Coyer Fiona, Chaboyer Wendy, Lin Frances, Doubrovsky Anna, Barakat-Johnson Michelle, Brown Wendy, Lakshmanan Ramanathan, Leslie Gavin, Jones Sarah L, Pearse India, Martin Kerrie, McInnes Elizabeth, Powell Madeleine, Mitchell Marion L, Sosnowski Kellie, Tallot Mandy, Thompson Amy, Thompson Lorraine, Labeau Sonia, Blot Stijn
Joint Appointment School of Nursing, Queensland University of Technology and Intensive Care Services, Royal Brisbane and Women's Hospital, Australia; Institute for Skin Integrity and Infection Prevention, University of Huddersfield, UK.
National Health and Medical Research Council Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland, Griffith University, Australia.
Aust Crit Care. 2022 Nov;35(6):701-708. doi: 10.1016/j.aucc.2021.10.009. Epub 2021 Nov 27.
Pressure injuries (PIs) are an enduring problem for patients in the intensive care unit (ICU) because of their vulnerability and numerous risk factors.
This study reports Australian data as a subset of data from an international 1-day point prevalence study of ICU-acquired PI in adult patients. Patients aged 18 years or older and admitted to the ICU on the study day were included. The outcome measure was the identification of a PI by direct visual skin assessment on the study day. Data collected included demographic data and clinical risk factors, PI location and stage, and PI prevention strategies used. Descriptive statistics were used to describe PI characteristics, and odds ratios (ORs) were used to identify factors associated with the development of a PI.
Data were collected from 288 patients from 16 Australian ICUs. ICU-acquired PI prevalence was 9.7%, with 40 PIs identified on 28 patients. Most PIs were of stage 1 and stage 2 (26/40, 65.0%). Half of the ICU-acquired PIs were found on the head and face. The odds of developing an ICU-acquired PI increased significantly with renal replacement therapy (OR: 4.25, 95% confidence interval [CI]: 1.49-12.11), impaired mobility (OR: 3.13, 95% CI: 1.08-9.12), fastest respiratory rate (OR: 1.05 [per breath per minute], 95% CI: 1.00-1.10), longer stay in the ICU (OR: 1.04 [per day], 95% CI: 1.01-1.06), and mechanical ventilation on admission (OR: 0.36, CI: 0.14-0.91).
This study found that Australian ICU-acquired PI prevalence was 9.7% and these PIs were associated with many risk factors. Targeted PI prevention strategies should be incorporated into routine prevention approaches to reduce the burden of PIs in the Australian adult ICU patient population.
由于重症监护病房（ICU）患者的脆弱性和众多风险因素，压力性损伤（PI）一直是困扰他们的问题。
本研究报告了澳大利亚的数据，这些数据是一项针对成年患者ICU获得性PI的国际1日点患病率研究数据的子集。纳入年龄在18岁及以上且在研究日入住ICU的患者。结局指标是在研究日通过直接目视皮肤评估识别出PI。收集的数据包括人口统计学数据和临床风险因素、PI的位置和阶段以及所采用的PI预防策略。使用描述性统计来描述PI的特征，并使用比值比（OR）来识别与PI发生相关的因素。
从澳大利亚16个ICU的288名患者中收集了数据。ICU获得性PI的患病率为9.7%，在28名患者中识别出40处PI。大多数PI为1期和2期（26/40，65.0%）。一半的ICU获得性PI出现在头部和面部。接受肾脏替代治疗（OR：4.25，95%置信区间[CI]：1.49 - 12.11）、活动能力受损（OR：3.13，95% CI：1.08 - 9.12）、最快呼吸频率（OR：1.05[每分钟每呼吸次数]，95% CI：1.00 - 1.10）、在ICU停留时间更长（OR：1.04[每天]，95% CI：1.01 - 1.06）以及入院时接受机械通气（OR：0.36，CI：0.14 - 0.91）会使发生ICU获得性PI的几率显著增加。
本研究发现澳大利亚ICU获得性PI的患病率为9.7%，且这些PI与许多风险因素相关。应将针对性的PI预防策略纳入常规预防方法中，以减轻澳大利亚成年ICU患者群体中PI的负担。
