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COVID-19 患者发生压力性损伤的特征:范围综述。

Characteristics of COVID-19 patients who developed pressure injuries: a scoping review.

机构信息

School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, Department of Nursing, University of Melbourne, Australia.

School of Nursing & Midwifery, La Trobe University, Melbourne, Australia.

出版信息

J Wound Care. 2023 Mar 1;32(Sup3):S9-S16. doi: 10.12968/jowc.2023.32.Sup3.S9.

Abstract

OBJECTIVE

To describe the characteristics of patients with COVID-19 who developed pressure injuries (PIs), the characteristics of PIs experienced, and the incidence and prevalence of PIs among the patients with COVID-19. PIs are associated with increased morbidity, mortality and healthcare expense. PIs have been reported among patients who have contracted COVID-19. Understanding the characteristics of COVID-19 patients, and how PIs are prevented and managed, may inform care and optimise the outcomes for COVID-19-positive patients.

METHOD

A scoping review was conducted. All study designs, including grey literature, published in the English language from December 2019 to March 2021, reporting on patients with COVID-19 and PIs, were included.

RESULTS

In total, 27 publications (n=4820 patients) were included in the review. The reported incidence rate of PIs was 7.3-77.0%. The causative factors noted were: prone positioning (28.5%); medical devices (21.4%); and medical devices used during prone positioning (14.2%). The most common PI sites were the cheeks (18.7%). PIs occurred on average at 14.7 days post-acute care admission. Of the PIs where staging information was specified (67.7%), the most common was Stage 2/II (45.2%). PI risk may intensify on account of the intrinsic mechanism of COVID-19-associated intensive care treatment.

CONCLUSION

PI prevention and management should be prioritised for patients with COVID-19, given the reported high prevalence of PIs and exacerbated risk arising from the use of prone position and medical devices. Further research is required to understand the association between COVID-19 and PIs, and to guide effective prevention and treatment approaches.

摘要

目的

描述发生压力性损伤(PI)的 COVID-19 患者的特征、患者经历的 PI 特征,以及 COVID-19 患者中 PI 的发生率和流行率。PI 与发病率、死亡率和医疗费用增加有关。有报道称 COVID-19 患者发生 PI。了解 COVID-19 患者的特征,以及如何预防和管理 PI,可能有助于为 COVID-19 阳性患者提供护理并优化其结果。

方法

进行了范围综述。纳入了所有研究设计,包括灰色文献,于 2019 年 12 月至 2021 年 3 月期间以英文发表,报告 COVID-19 患者和 PI 的研究。

结果

综述共纳入 27 篇文献(n=4820 例患者)。报告的 PI 发生率为 7.3-77.0%。指出的致病因素有:俯卧位(28.5%);医疗器械(21.4%);以及俯卧位时使用的医疗器械(14.2%)。最常见的 PI 部位是脸颊(18.7%)。PI 平均在急性护理入院后 14.7 天发生。在明确分期信息的 PI 中(67.7%),最常见的是 2 期/Ⅱ期(45.2%)。由于 COVID-19 相关重症监护治疗的内在机制,PI 风险可能会加剧。

结论

鉴于报告的 PI 高发生率和由于使用俯卧位和医疗器械而加剧的风险,应优先为 COVID-19 患者预防和管理 PI。需要进一步研究以了解 COVID-19 与 PI 之间的关联,并指导有效的预防和治疗方法。

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