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A prospective, descriptive study of risk factors related to pressure ulcer development among patients in intensive
Elçin Ülker Efteli1, Ülkü Yapucu Günes
1Department of Fundamentals of Nursing, Ege University Faculty of Nursing, Izmir, Turkey.
Insights
In intensive care units (ICUs), female gender and low serum albumin are key risk factors for developing pressure ulcers (PUs). These findings highlight critical areas for prevention strategies in high-risk patients.
Area of Science:
- Critical Care Medicine
- Nursing Research
- Dermatology
Background:
- Pressure ulcers (PUs) are a significant concern in hospital settings, with established risk factors in the general population.
- However, specific risk factors for PU development in critical care patients remain less defined, necessitating targeted research.
Purpose of the Study:
- To determine the incidence of pressure ulcers in high-risk intensive care unit (ICU) patients.
- To identify independent risk factors associated with PU development in this vulnerable patient group.
Main Methods:
- A prospective, descriptive study was conducted in a Turkish university hospital's ICU.
- Data collected included demographics, APACHE II scores, serum albumin, hemoglobin, glucose, and daily skin assessments for patients with a Braden scale score <12.
- Statistical analyses involved t-tests, chi-square, and logistic regression.
Main Results:
- The study included 70 high-risk ICU patients (mean age 56.2 years).
- The incidence of pressure ulcers was 28.6% during an average ICU stay of 17.2 days.
- Multivariate logistic regression identified female gender (OR=0.15) and lower serum albumin levels (OR=11.6) as independent risk factors for PU development.
Conclusions:
- Female gender and low serum albumin levels are significant independent risk factors for pressure ulcer development in intensive care unit patients.
- These factors should be considered in risk assessment and prevention protocols for ICU populations.
- Further large-scale prospective studies are recommended to validate these findings.
Abstract:
Many risk factors for the development of pressure ulcers (PUs) in the general hospital population have been identified, but consensus is lacking on specific PU risk factors for critical care patients. A prospective, descriptive study was conducted to determine the incidence of and risk factors for PU development among high-risk patients (Braden risk scale score <12) admitted to an intensive care unit (ICU) of a university hospital in Turkey. Demographic variables, APACHE II scores, serum albumin, hemoglobin, and glucose levels were obtained, and patients' skin was assessed daily until discharge. Data were analyzed using percentage distributions, Student's t-test, chi-square, and logistic regression analysis. Seventy (70) patients (22 women, 48 men), average age 56.2 (SD 19.2) years, mean albumin level 2.86 (median: 2.86, SD 2.73), and mean APACHE II score 17.2 (SD 6.48), completed the study. During an average length of stay of 17.2 days (SD 4.2), PU incidence was 28.6%. Of the 23 ulcers that developed, 12 (52.1%) were Stage I, eight (8, 34.8%) were Stage II, and three (3, 13.1%) were Stage III; no patient developed a Stage IV ulcer. Multivariate logistic regression analysis showed that being female (OR = 0.15, [95% CI:0.03- 0.71] P <0.05) and having a lower serum albumin level (OR=11.6, [95% CI:1.92- 70.4] P <0.01) were independent risk factors for PU development. Patient gender and serum albumin levels should be considered as risk factors for PU development in ICU patients. Larger prospective studies examining these risk factors in ICU patients are warranted.
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