Pressure injuries in elderly with acute myocardial infarction

Area of Science:

• Cardiology
• Gerontology
• Nursing Science

Background:

• Pressure injuries (PIs) are a significant concern in hospitalized patients, particularly those with acute myocardial infarction (AMI).
• Intensive coronary care units (ICCU) present unique challenges for PI prevention due to patient acuity.
• Understanding PI risk factors in this population is crucial for targeted interventions.

Purpose of the Study:

• To determine the incidence of PIs in patients hospitalized for AMI within an ICCU.
• To identify specific risk factors associated with PI development in this patient cohort.
• To evaluate the predictive value of these factors for improving clinical management.

Main Methods:

• Prospective cohort study involving 165 patients admitted to an ICCU for AMI.
• Data collection included the Norton Scale, Mini Nutritional Assessment (MNA), demographics, clinical, and biochemical parameters upon admission.
• Logistic regression, jackknifed area under the receiver operating characteristic curve (AUC), and decision curve analysis were used to assess risk factors and predictive value.

Main Results:

• The incidence of PIs was 16.3% (27 out of 165 patients).
• Independent predictors of increased PI risk included advanced age, lower left ventricular ejection fraction (LVEF), lower MNA scores, and lower Norton Scale scores.
• Inclusion of LVEF in the predictive model significantly improved its discrimination power and clinical utility.

Conclusions:

• Age, LVEF, Norton Scale, and MNA scores are strong, independent predictors of in-hospital PI development in AMI patients.
• These validated risk factors can enhance the clinical management of patients admitted to the ICCU.
• This study provides a foundation for developing targeted PI prevention strategies in critical cardiac care settings.