James Canfor, Masters of Podiatric Practice, Podiatry Department, Peninsula Health, Frankston, Victoria, Australia.
Lucia Michailidis, PhD, Podiatry Department, Peninsula Health, Frankston, Victoria, Australia.
J Wound Ostomy Continence Nurs. 2023;50(2):162-166. doi: 10.1097/WON.0000000000000956.
The purpose of this study was to measure the incidence of suspected deep tissue pressure injuries (DTPIs) in patients admitted to the hospital, describe their location, identify the related hospital length of stay, and explore any associations between intrinsic or extrinsic factors relevant to DTPI development.
Retrospective review/audit of clinical data.
We reviewed pertinent medical data from patients reported as developing a suspected deep tissue injury during hospital admission from January 2018 to March 2020. The study setting was a large tertiary public health service in Victoria, Australia.
Patients who developed a suspected deep tissue injury during hospital admission between January 2018 and March 2020 were identified through the hospital online risk recording system. Data were extracted from the relevant health records, including demographics, admission data, and pressure injury data. The incidence rate was expressed per 1000 patient admissions. Multiple regression analyses were used to determine associations between the time (days) to develop a suspected deep tissue injury and intrinsic (patient level) or extrinsic (hospital level) factors.
Six hundred fifty-one pressure injuries were recorded during the audit period. A minority (9.5%; n = 62) of patients developed a suspected deep tissue injury; all were located on the foot and ankle. The incidence of suspected deep tissue injuries was 0.18 per 1000 patient admissions. The mean length of stay among patients who developed a DTPI was 59.0 (SD = 51.9) days as compared to a mean of 4.2 (SD = 11.8) days for all patients admitted to the hospital during this period. Multivariate regression analysis determined that the longer time (in days) to develop a pressure injury was associated with having a higher body weight (Coef = 0.02; 95% CI = 0.00 to 0.04; P = .043), not having off-loading (Coef =-3.63; 95% CI =-6.99 to -0.27; P = .034), and an increasing number of ward transfers (Coef = 0.46; 95% CI = 0.20 to 0.72; P = .001).
Findings identified factors that may play a role in the development of suspected deep tissue injuries. A review of risk stratification in health services may be beneficial, with consideration to adjustments of procedural assessments of patients at risk.
本研究旨在测量住院患者疑似深部组织压力性损伤（DTPIs）的发生率，描述其位置，确定与 DTPIs 发展相关的住院时间，并探讨与 DTPI 发展相关的内在或外在因素之间的任何关联。
临床数据的回顾性审查/审核。
我们回顾了 2018 年 1 月至 2020 年 3 月期间在医院住院期间发生疑似深部组织损伤的患者的相关医疗数据。研究地点是澳大利亚维多利亚州的一家大型三级公立卫生服务机构。
通过医院在线风险记录系统确定 2018 年 1 月至 2020 年 3 月期间住院期间发生疑似深部组织损伤的患者。从相关健康记录中提取数据，包括人口统计学、入院数据和压力性损伤数据。发病率以每 1000 例患者入院为单位表示。使用多元回归分析确定疑似深部组织损伤发生的时间（天数）与内在（患者水平）或外在（医院水平）因素之间的关联。
在审核期间记录了 651 例压力性损伤。少数（9.5%；n=62）患者发生疑似深部组织损伤；均位于足部和踝关节。疑似深部组织损伤的发生率为每 1000 例患者入院 0.18 例。发生 DTPI 的患者的平均住院时间为 59.0（SD=51.9）天，而在此期间所有住院患者的平均住院时间为 4.2（SD=11.8）天。多变量回归分析确定，发生压力性损伤的时间（天数）越长，体重越高（Coef=0.02；95%CI=0.00 至 0.04；P=0.043）、未减压（Coef=-3.63；95%CI=-6.99 至 -0.27；P=0.034）以及病房转移次数增加（Coef=0.46；95%CI=0.20 至 0.72；P=0.001）的可能性越大。
研究结果确定了可能在疑似深部组织损伤发展中起作用的因素。对卫生服务机构的风险分层进行审查可能会有所帮助，同时考虑对有风险的患者进行程序性评估的调整。
