危重症患者重症监护病房获得性骶骨压力性损伤的发生率及危险因素：一项中国多中心横断面研究
Frequency of and risk factors for intensive care unit-acquired sacrum pressure injuries in critically ill patients: A multicenter cross-sectional study in China.
作者信息
Hu Binqin, Zhao Yang, Yang Jijun, Zeng Zhenhua, Wu Yanhong, Gui Chunmei, Gong Jiang, Gao Yi, Yang Yong, Luo Cuizhu, Wang Yu, Jiang Qingjuan, Guo Wenlong, Lu Pan, Yuan Fen, Li Xiaofang, Dai Xingui
机构信息
Department of Critical Care Medicine Affiliated to the First People's Hospital of Chenzhou, University of South China Chenzhou China.
Department of Critical Care Medicine The Fourth People's Hospital of Chenzhou Chenzhou China.
出版信息
Health Sci Rep. 2021 Oct 22;4(4):e390. doi: 10.1002/hsr2.390. eCollection 2021 Dec.
RATIONALE AIMS AND OBJECTIVES
Hospital-acquired pressure injuries (HAPI) prolong hospital stays and are an important health problem worldwide. The aim of this study was to assess the frequency of and risk factors for intensive care unit (ICU)-acquired pressure injuries (IAPI) on the sacrum in critically ill patients in China.
METHODS
We performed a multicenter, cross-sectional survey of IAPI on the sacrum in 23 adult ICUs in 19 hospitals in China. Data for 421 critically ill patients were collected on December 13, 2019, and January 13, 2020, including patient characteristics, physiological, and clinical information. Logistic regression was used to analyze the risk factors for IAPI on the sacrum in the ICU.
RESULTS
Forty-one patients presented sacrum pressure injuries in the ICU, with a frequency of 9.74%. Risk factors that significantly increased the risk of IAPI on the sacrum were lower body mass index (BMI, odds ratio [OR] = 1.115, confidence interval [CI]: 1.011-1.229, = .029), chronic obstructive pulmonary disease (COPD, OR = 3.183, CI: 1.261-8.037, = .014), multiple organ dysfunction syndrome (MODS, OR = 2.670, CI: 1.031-6.903, = .043), and a lower Braden risk score (OR = 1.409, CI: 1.197-1.659, < .001).
CONCLUSION
Lower BMI, COPD, MODS, and lower Braden risk score are independent risk factors for sacrum IAPI in China.
理论依据、目的和目标：医院获得性压力性损伤（HAPI）会延长住院时间，是全球范围内的一个重要健康问题。本研究的目的是评估中国重症患者骶骨部位的重症监护病房（ICU）获得性压力性损伤（IAPI）的发生频率及危险因素。
方法
我们对中国19家医院的23个成人ICU中骶骨部位的IAPI进行了多中心横断面调查。于2019年12月13日和2020年1月13日收集了421例重症患者的数据，包括患者特征、生理和临床信息。采用逻辑回归分析ICU中骶骨部位IAPI的危险因素。
结果
41例患者在ICU发生了骶骨压力性损伤，发生率为9.74%。显著增加骶骨部位IAPI风险的危险因素包括较低的体重指数（BMI，比值比[OR]=1.115，置信区间[CI]：1.011-1.229，P=.029）、慢性阻塞性肺疾病（COPD，OR=3.183，CI：1.261-8.037，P=.014）、多器官功能障碍综合征（MODS，OR=2.670，CI：1.031-6.903，P=.043）以及较低的Braden风险评分（OR=1.409，CI：1.197-1.659，P<.001）。
结论
在中国，较低的BMI、COPD、MODS以及较低的Braden风险评分是骶骨IAPI的独立危险因素。
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