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终末期压疮患者病灶周围皮肤状况与生存的关系

Relationship Between Perilesional Skin Condition and Survival in Terminally Ill Patients with Pressure Ulcers.

作者信息

Pastor-Orduña María Isabel, Palomar-Llatas Federico, Palomar-Albert David, Murillo-Llorente María Teresa, Ventura Ignacio, Tomás-Aguirre Francisco, Pérez-Bermejo Marcelino

机构信息

Doctoral School, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain.

Chair of Integrity and Skin Care, Integrity and Skin Care Research Group, Catholic University of Valencia San Vicente Mártir, 46001 Valencia, Spain.

出版信息

Medicina (Kaunas). 2025 Jan 17;61(1):147. doi: 10.3390/medicina61010147.

Abstract

In the context of palliative care, the aim is to alleviate suffering and improve quality of life, with particular attention to PUs, which have a significant impact on quality of life and survival. This study examines the relationship between perilesional skin condition and survival in terminally ill patients with pressure ulcers (PUs). A descriptive and observational study was conducted in two hospitals in Valencia with a sample of 100 terminally ill patients. Sociodemographic, clinical and PPU-specific variables were assessed using validated scales such as FEDPALLA-II and the Barthel Index. Although it is a study of an observational nature, which may preclude establishing causality, the results showed that functional capacity, perilesional tissue epithelialization, and albumin levels were significant predictors of survival, while the number and location of PUs had no direct impact. Perilesional tissue epithelialization was highlighted as a critical indicator reflecting the systemic stability of the patient. The study highlights the importance of a comprehensive approach to palliative care that addresses both the local aspects of the lesions and the patient's systemic and functional status. These findings support the implementation of therapeutic interventions based on a structured perilesional tissue assessment to improve quality of life and prolong survival in terminally ill patients. In addition, a positive correlation was found between Barthel Score and survival, suggesting that patients with greater functional independence have a longer life expectancy. On the other hand, the negative correlation between total lymphocyte count and survival suggests that lymphocytopenia may be a marker of adaptive immunosuppression. Perilesional tissue epithelialization, overall functionality and serum albumin levels are key factors in predicting survival, highlighting the need for a comprehensive palliative care approach to optimize quality of life and prolong survival in terminally ill patients with PUs.

摘要

在姑息治疗的背景下,目标是减轻痛苦并改善生活质量,尤其要关注压疮,因为压疮对生活质量和生存期有重大影响。本研究探讨了终末期压疮患者病灶周围皮肤状况与生存期之间的关系。在巴伦西亚的两家医院进行了一项描述性观察性研究,样本为100名终末期患者。使用经过验证的量表(如FEDPALLA-II和Barthel指数)评估社会人口统计学、临床和压疮特异性变量。尽管这是一项观察性研究,可能无法确定因果关系,但结果表明,功能能力、病灶周围组织上皮化和白蛋白水平是生存期的重要预测因素,而压疮的数量和位置没有直接影响。病灶周围组织上皮化被视为反映患者全身稳定性的关键指标。该研究强调了姑息治疗综合方法的重要性,这种方法既要解决病灶的局部问题,也要关注患者的全身和功能状态。这些发现支持基于结构化病灶周围组织评估实施治疗干预,以改善终末期患者的生活质量并延长生存期。此外,发现Barthel评分与生存期之间存在正相关,这表明功能独立性较强的患者预期寿命更长。另一方面,总淋巴细胞计数与生存期之间的负相关表明淋巴细胞减少可能是适应性免疫抑制的一个指标。病灶周围组织上皮化、整体功能和血清白蛋白水平是预测生存期的关键因素,这突出了需要采取全面的姑息治疗方法来优化终末期压疮患者的生活质量并延长生存期。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d7aa/11767001/61dce4dee28a/medicina-61-00147-g001.jpg

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