Pressure Injuries at Intensive Care Unit Admission as a Prognostic Indicator of Patient Outcomes

Area of Science:

• Critical care medicine
• Patient outcomes research
• Wound care

Background:

• Pressure injuries (pressure ulcers) are a significant complication for immobile patients.
• Early identification of pressure injuries upon intensive care unit (ICU) admission is crucial for effective treatment.
• The correlation between community-acquired pressure injuries and adverse outcomes in critically ill patients requires further investigation.

Purpose of the Study:

• To investigate if pressure injuries present at ICU admission predict longer hospital stays and increased mortality.
• To establish pressure injuries as a potential predictive marker for critical care outcomes.

Main Methods:

• Retrospective analysis of adult ICU admissions from 2010-2012 at a level I trauma center.
• Multivariable logistic regression and generalized linear models were used to assess the association between pressure injuries and outcomes.
• Analyses were adjusted for patient characteristics including age, comorbidities, and the Acute Physiology and Chronic Health Evaluation III score.

Main Results:

• Of 2723 patients, 180 (6.6%) had an admission pressure injury.
• Patients with pressure injuries had significantly longer unadjusted hospital stays (15.6 vs 10.5 days) and higher mortality (32.2% vs 18.3%).
• Multivariable analysis revealed pressure injuries were associated with a 3.1-day increase in length of stay; however, the association with mortality was not significant after adjusting for the APACHE III score.

Conclusions:

• Admission pressure injuries are an objective, easily identifiable factor linked to extended ICU stays.
• Pressure injuries may serve as a modest indicator of increased mortality risk, particularly when comprehensive scoring data is absent.