英国重症监护患者皮肤压力损伤的患病率：对成年重症监护患者进行的单日患病率评估结果。
Prevalence of skin pressure injury in critical care patients in the UK: results of a single-day point prevalence evaluation in adult critically ill patients.
机构信息
Intensive Care Medicine, McGill University, Montreal, Quebec, Canada
Montreal General Hospital, Montreal, Quebec, Canada.
出版信息
BMJ Open. 2022 Nov 23;12(11):e057010. doi: 10.1136/bmjopen-2021-057010.
OBJECTIVES
Hospital-acquired pressure injuries (PIs) are a source of morbidity and mortality, and many are potentially preventable.
DESIGN
This study prospectively evaluated the prevalence and the associated factors of PIs in adult critical care patients admitted to intensive care units (ICU) in the UK.
SETTING
This service evaluation was part of a larger, international, single-day point prevalence study of PIs in adult ICU patients. Training was provided to healthcare givers using an electronic platform to ensure standardised recognition and staging of PIs across all sites.
PARTICIPANTS
The characteristics of the ICUs were recorded before the survey; deidentified patient data were collected using a case report form and uploaded onto a secure online platform.
PRIMARY AND SECONDARY OUTCOME MEASURES
Factors associated with ICU-acquired PIs in the UK were analysed descriptively and using mixed multiple logistic regression analysis.
RESULTS
Data from 1312 adult patients admitted to 94 UK ICUs were collected. The proportion of individuals with at least one PI was 16% (211 out of 1312 patients), of whom 8.8% (n=115/1312) acquired one or more PIs in the ICU and 7.3% (n=96/1312) prior to ICU admission. The total number of PIs was 311, of which 148 (47.6%) were acquired in the ICU. The location of majority of these PIs was the sacral area, followed by the heels. Braden score and prior length of ICU stay were associated with PI development.
CONCLUSIONS
The prevalence and the stage of severity of PIs were generally low in adult critically ill patients admitted to participating UK ICUs during the study period. However, PIs are a problem in an important minority of patients. Lower Braden score and longer length of ICU stay were associated with the development of injuries; most ICUs assess risk using tools which do not account for this.
TRIAL REGISTRATION NUMBER
NCT03270345.
目的
医院获得性压疮（PI）是发病率和死亡率的一个来源，许多压疮是可以预防的。
设计
本研究前瞻性评估了英国重症监护病房（ICU）成年危重症患者 PI 的患病率及其相关因素。
设置
这项服务评估是更大的、国际的、单一的 ICU 成年患者 PI 患病率的一部分。使用电子平台向医护人员提供培训，以确保所有站点 PI 的标准化识别和分期。
参与者
在调查前记录了 ICU 的特征；使用病例报告表收集了匿名患者数据，并上传到安全的在线平台。
主要和次要结果
对英国 ICU 获得性 PI 的相关因素进行了描述性和混合多因素逻辑回归分析。
结果
从英国 94 家 ICU 收治的 1312 名成年患者中收集了数据。至少有一个 PI 的个体比例为 16%（1312 例患者中有 211 例），其中 8.8%（n=115/1312）在 ICU 中获得一个或多个 PI，7.3%（n=96/1312）在 ICU 入院前获得。PI 总数为 311 个，其中 148 个（47.6%）在 ICU 获得。这些 PI 的大部分位于骶骨区域，其次是脚跟。Braden 评分和 ICU 入住前的时间与 PI 的发生有关。
结论
在研究期间，入住英国参与 ICU 的成年危重症患者 PI 的患病率和严重程度通常较低。然而，PI 是一个重要的少数患者的问题。较低的 Braden 评分和较长的 ICU 入住时间与损伤的发展有关；大多数 ICU 使用的工具不考虑这一点来评估风险。
试验注册号
NCT03270345。
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