Pérez-Juan E, Maqueda-Palau M, Feliu-Roig C, Gómez-Arroyo J M, Sáez-Romero D, Ortiz-Monjo A
Unidad de Cuidados Intensivos. Hospital Comarcal de Manacor, Manacor, España.
Institut d'investigació sanitària Illes Balears (idISBa), Cures cronicitat i evidències en salut (cuREs), Palma, España.
Enferm Intensiva. 2023 Mar 14. doi: 10.1016/j.enfi.2022.12.001.
The appearance of pressure ulcers (PU) is one of the frequent complications of prone position (PP), due to prolonged pressure and shear forces.
To compare the incidence of pressure ulcers secondary to prone position and describe their location among four Intensive Care Units (ICU) of public hospitals.
Multicenter descriptive and retrospective observational study. The population consisted of patients admitted to the ICU between February 2020 and May 2021, diagnosed with Covid-19 who required prone decubitus. The variables studied were sociodemographic, days of admission to the ICU, total hours on PP, PU prevention, location, stage, frequency of postural changes, nutrition and protein intake. Data collection was carried out through the clinical history of the different computerized databases of each hospital. Descriptive analysis and association between variables were performed using SPSS vs.20.0.
A total of 574 patients were admitted for Covid-19, 43.03% were pronated. 69.6% were men, median age was 66 (IQR 55-74) and BMI 30.7 (RIC 27-34.2). Median ICU stay was 28 days (IQR 17-44.2), median hours on PD per patient 48 h (IQR 24-96). The incidence of PU occurrence was 56.3%, 76.2% of patients presented a PU, the most frequent location was the forehead (74.9%). There were significant differences between hospitals in terms of PU incidence (p = 0.002), location (p < 0.001) and median duration of hours per PD episode (p = 0.001).
The incidence of pressure ulcers due to the prone position was very high. There is great variability in the incidence of pressure ulcers between hospitals, location and average duration of hours per episode of prone position.
由于长时间的压力和剪切力，压疮（PU）的出现是俯卧位（PP）常见的并发症之一。
比较俯卧位继发压疮的发生率，并描述公立四家重症监护病房（ICU）中压疮的发生部位。
多中心描述性回顾性观察研究。研究对象为2020年2月至2021年5月期间入住ICU、被诊断为新冠肺炎且需要俯卧位的患者。研究变量包括社会人口统计学特征、入住ICU天数、俯卧位总时长、压疮预防措施、部位、分期、体位改变频率、营养状况和蛋白质摄入量。通过各医院不同计算机数据库中的临床病历进行数据收集。使用SPSS 20.0进行描述性分析和变量间关联分析。
共有574例新冠肺炎患者入院，43.03%采用了俯卧位。男性占69.6%，中位年龄为66岁（四分位间距55 - 74），体重指数为30.7（四分位间距27 - 34.2）。ICU中位住院时间为28天（四分位间距17 - 44.2），每位患者俯卧位的中位时长为48小时（四分位间距24 - 96）。压疮发生率为56.3%，76.2%的患者出现了压疮，最常见的部位是前额（74.9%）。不同医院在压疮发生率（p = 0.002）、部位（p < 0.001）和每次俯卧位发作的中位时长（p = 0.001）方面存在显著差异。
俯卧位导致的压疮发生率非常高。不同医院间压疮发生率、部位以及每次俯卧位发作的平均时长存在很大差异。
