Vieira Sofia, Mostardinha António, Alves Paulo
Center for Interdisciplinary Research in Health|CIIS, Wounds Research Lab, Faculdade de Ciências da Saúde e Enfermagem, Universidade Católica Portuguesa, 4169-005 Porto, Portugal.
Intensive Care Department, Hospital Dr. Nélio Mendonça, Serviço de Saúde da Região Autónoma da Madeira, EPERAM, 9000-177 Funchal, Portugal.
Nurs Rep. 2024 Nov 1;14(4):3291-3309. doi: 10.3390/nursrep14040239.
This study describes the epidemiological changes in pressure ulcers (PUs) in a Portuguese intensive care unit (ICU) from January 2017 to June 2023, characterizes critically ill patients with PUs, identifies specific risk factors, and assesses the effectiveness of implemented preventive measures.
A retrospective observational cohort study was conducted, analyzing records of ICU patients with PUs during the specified period. Data were extracted from the institution's Global Risk Management application and the ICU's electronic PU registry. The study included patients with ICU stays longer than 24 h and excluded those with ineligible clinical records or incomplete characterization data.
Among 3816 evaluated patients, 257 developed a total of 345 PUs, averaging 1.4 PUs per patient. The average PU prevalence rate was 6.81%, with the highest prevalence in 2020 (11.0%) and the lowest in 2022 (3.48%). The average incidence rate was 3.76%, peaking at 5.71% in 2020 and declining to 2.54% in 2023. The sacrum and heels were the most commonly affected areas, with Category 2 PUs being the most frequent. Key intrinsic risk factors included systemic diseases and sensory deficits, with pressure identified as a significant extrinsic factor. Preventive measures focused on risk assessment and pressure control.
The study reveals a PU prevalence of 6.81% and an average incidence of 3.76%, underscoring the need for enhanced preventive strategies, especially in anatomical areas like the sacrum and heels. It emphasizes the importance of personalized assessments, continuous education for nursing staff, and a multidisciplinary approach to improve patient outcomes and care quality in the ICU.
本研究描述了2017年1月至2023年6月葡萄牙一家重症监护病房（ICU）中压疮（PU）的流行病学变化，对患有压疮的重症患者进行特征描述，识别特定风险因素，并评估所实施预防措施的有效性。
进行了一项回顾性观察队列研究，分析指定期间ICU中患有压疮患者的记录。数据从该机构的全球风险管理应用程序和ICU的电子压疮登记册中提取。该研究纳入了在ICU住院时间超过24小时的患者，并排除了临床记录不合格或特征数据不完整的患者。
在3816名评估患者中，257名患者共发生了345处压疮，平均每位患者1.4处压疮。压疮平均患病率为6.81%，2020年患病率最高（11.0%），2022年最低（3.48%）。平均发病率为3.76%，2照020年达到峰值5.71%，2023年降至2.54%。骶骨和足跟是最常受影响的部位，2期压疮最为常见。主要的内在风险因素包括全身性疾病和感觉缺陷，压力被确定为一个重要的外在因素。预防措施侧重于风险评估和压力控制。
该研究显示压疮患病率为6.81%，平均发病率为3.76%，强调了加强预防策略的必要性，特别是在骶骨和足跟等解剖部位。它强调了个性化评估、对护理人员进行持续教育以及采用多学科方法以改善ICU患者结局和护理质量的重要性。
