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Skin lesions in the ICU
M Badia1, J Trujillano, E Gascó
1Intensive Care Unit, Hospital Universitario Arnau de Vilanova, Lleida, Spain. marionabadia@mx3.redestb.es
Insights
Dermatological disorders (DDs) in intensive care units (ICUs) are common, affecting 10% of patients. While not significantly impacting mortality, these skin conditions are linked to longer ICU stays and higher severity scores.
Area of Science:
- Critical Care Medicine
- Dermatology
- Epidemiology
Background:
- Skin lesions are frequently observed in intensive care unit (ICU) patients.
- The specific dermatological disorders (DDs) and their clinical impact in the ICU setting require further elucidation.
Purpose of the Study:
- To identify the most common dermatological disorders (DDs) in ICU patients.
- To determine the incidence of these DDs.
- To assess the impact of DDs on patient mortality, disease severity, and length of ICU stay.
Main Methods:
- A 2-year prospective study was conducted in a general medical and surgical ICU.
- All patients presenting with skin lesions on admission or during their ICU stay were included, encompassing pediatric cases.
- Data collected included demographic information, diagnosis of DDs, severity scores (SAPS II), and patient outcomes.
Main Results:
- Forty-six patients (10% of total admissions) were enrolled, with 51 diagnosed DDs.
- Patients with DDs had significantly higher SAPS II scores (43) and a longer mean ICU stay (19 days) compared to the general ICU population.
- Mortality rates between patients with and without DDs were not statistically significant (26% vs. 29%).
Conclusions:
- Dermatological disorders are a notable concern in critically ill patients, with a non-negligible incidence.
- Routine skin examination upon admission and throughout the ICU stay is crucial for timely diagnosis and management of DDs.
- While not directly increasing mortality, DDs are associated with increased disease severity and prolonged hospitalization in the ICU.
Objective:
The objective of this study is to identify the dermatological disorders (DDs) responsible for the most common skin lesions in the ICU, their incidence and their impact on mortality, degree of severity and length of stay in the ICU.
Design And Setting:
We performed a 2-year prospective study in a general medical and surgical ICU including, exceptionally, paediatric cases.
Patients:
We included all patients who presented skin lesions upon admission or developed them during their ICU stay.
Results:
Forty-six patients (10% of all admissions) were enrolled, with 51 DDs. SAPS II score (43) and mean length of stay (19 days) were significantly higher than in the general group of ICU admissions. Differences in mortality rates (26% versus 29%) were not statistically significant.
Conclusions:
DDs are entities that should be borne in mind in the critically ill patient; their incidence is by no means negligible and makes careful examination of the skin mandatory both on admission and during a patient's ICU stay.