Behavioral Disease Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Int Wound J. 2022 Dec;19(8):2039-2054. doi: 10.1111/iwj.13804. Epub 2022 Mar 23.
The pandemic of coronavirus (COVID-19) has significantly increased the admission of patients with extensive complications, especially for respiratory support, to intensive care units (ICUs) worldwide. These patients also suffer from pressure ulcers (PUs) as another complication that occurs due to increased length of hospitalisation and acute conditions of patients. Therefore, this study aimed to evaluate the incidence and prevalence of PU and the factors affecting it in COVID-19 patients admitted to ICUs. This cohort retrospective study used registry data in Imam Reza Hospital located in west of Iran. Four hundred and forty-five COVID-19 patients older than 20 years hospitalised in corona ICUs from 20 March 2020 to 30 December 2020, with a Braden score of less than 14 were included in the study. To investigate the relationship between variables in rate prevalence, univariate logistic regression analysis was used to calculate odds ratio, and for incidence rate in estimating PU risk generated in ICUs, hazard ratio was calculated using cox regression. One hundred and eighty-three (41.12%) patients were male. The mean age of patients was 63 (SD = ±9.78) years. A total of 1152 cases of PU were generated, with the highest prevalence of PU with 234 cases in the sacrum. One hundred and seventy-six (55.87%) patients underwent non-invasive ventilation ulcers. The prevalence of PU was 79.7%. The highest prevalence was found in people over 80 years with 90.67%. The incidence ratio was 46.74%. The highest number of new cases was seen in diabetic patients with 60.96%. First-degree ulcers were the most common degree of ulceration in 252 (55.38%) patients. Incidence and prevalence excluding first-degree wounds were 24.04% and 49.66%, respectively. Age, Braden score, BMI, comorbidity, diabetes mellitus, stool incontinence, Glasgow coma scale, vasopressor, and length of hospital stay were significantly associated with PU (P < .05). The incidence and prevalence of PU in patients were high in this study. The length of hospitalisation and Braden score were the most important factors in the development of PU. The widespread prevalence of COVID-19 and the relatively long stay of patients in the ICU created unfavourable conditions for patients and the treatment system, therefore, it emphasised the use of appropriate measures to prevent PU to avoid double costs and longer stays.
冠状病毒（COVID-19）大流行显著增加了广泛并发症患者的入院率，尤其是需要呼吸支持的患者，这些患者也患有压力性溃疡（PU），这是由于住院时间延长和患者病情急性加重而发生的另一种并发症。因此，本研究旨在评估 ICU 中 COVID-19 患者 PU 的发生率和患病率以及影响其发病的因素。本队列回顾性研究使用了位于伊朗西部的礼萨医院的登记数据。纳入了 2020 年 3 月 20 日至 2020 年 12 月 30 日期间在 COVID-19 重症监护病房住院的年龄大于 20 岁且Braden 评分低于 14 的 445 名 COVID-19 患者。为了研究发生率和患病率中变量之间的关系，使用单变量逻辑回归分析计算比值比，为了估计 ICU 中产生的 PU 风险的发病率，使用 Cox 回归计算风险比。183 名（41.12%）患者为男性。患者的平均年龄为 63（SD=±9.78）岁。共发生 1152 例 PU，其中骶骨处的 PU 患病率最高，有 234 例。176 例（55.87%）患者发生无创通气溃疡。PU 的患病率为 79.7%。80 岁以上人群的患病率最高，为 90.67%。发病率为 46.74%。新发病例数最多的是糖尿病患者，为 60.96%。1 度溃疡是 252 例（55.38%）患者中最常见的溃疡程度。排除 1 度伤口后的发病率和患病率分别为 24.04%和 49.66%。年龄、Braden 评分、BMI、合并症、糖尿病、大便失禁、格拉斯哥昏迷评分、血管加压药和住院时间与 PU 显著相关（P<0.05）。本研究中患者的 PU 发生率和患病率较高。住院时间和 Braden 评分是 PU 发展的最重要因素。COVID-19 的广泛流行和患者在 ICU 中相对较长的停留时间为患者和治疗系统创造了不利条件，因此，强调使用适当的措施来预防 PU 以避免双重成本和更长的停留时间。
