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压力性溃疡复发的相关危险因素:国家数据库分析。

Risk factors associated with pressure ulcer recurrence after reconstruction: Analysis of a national database.

机构信息

Plastic Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.

出版信息

Wound Repair Regen. 2023 Sep-Oct;31(5):641-646. doi: 10.1111/wrr.13110. Epub 2023 Aug 28.

Abstract

In this study, we sought to clarify the patient traits and comorbidities that are associated with pressure injury recurrence following pressure injury reconstruction. An insurance claims database, PearlDiver, was used to conduct a retrospective cohort study. The two cohorts included patients who underwent pressure injury reconstruction without recurrence and patients who experienced recurrence with subsequent reconstruction. Multiple logistic regression analysis was used to identify risk factors for recurrence after reconstruction. Recurrence was associated with hypoalbuminemia (p < 0.05), paraplegia (p < 0.05), and osteomyelitis (p < 0.05). In patients with osteomyelitis, primary closure was associated with recurrence (p < 0.05) while flap reconstruction was not (p > 0.05). Osteomyelitis was not associated with recurrence after flap reconstruction. Prior to reconstruction, patients with osteomyelitis and hypoalbuminemia should have their nutrition and infection optimised.

摘要

在这项研究中,我们试图阐明与压力性损伤重建后压力性损伤复发相关的患者特征和合并症。使用保险索赔数据库 PearlDiver 进行回顾性队列研究。两个队列包括未复发压力性损伤重建的患者和随后进行重建的复发患者。多因素逻辑回归分析用于确定重建后复发的危险因素。复发与低白蛋白血症(p<0.05)、截瘫(p<0.05)和骨髓炎(p<0.05)相关。在患有骨髓炎的患者中,原发性闭合与复发相关(p<0.05),而皮瓣重建则没有(p>0.05)。骨髓炎与皮瓣重建后复发无关。在重建之前,患有骨髓炎和低白蛋白血症的患者应优化其营养和感染状况。

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