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Hospital-Acquired Pressure Injuries and Acute Skin Failure in Critical Care: A Case-Control Study.
Joyce Pittman1,2,3,4,5,6,7, Terrie Beeson1,2,3,4,5,6,7, Jill Dillon1,2,3,4,5,6,7
1Joyce Pittman, PhD, RN, ANP-BC, FNP-BC, CWOCN, FAAN, Indiana University Health-Academic Health Center, Indianapolis.
Summary
Critically ill patients with organ failure, sepsis, and moisture issues face higher risks of developing hospital-acquired pressure injuries (HAPIs). However, unavoidable HAPIs were not linked to acute skin failure risk factors in this study.
Area of Science:
- Critical care medicine
- Dermatology
- Nursing research
Background:
- Hospital-acquired pressure injuries (HAPIs) are a significant concern in critically ill patients.
- Identifying risk factors is crucial for prevention and management strategies.
Purpose of the Study:
- To examine clinical characteristics and risk factors associated with HAPIs in critically ill patients.
- To determine the proportion of validated unavoidable HAPIs linked to proposed acute skin failure (ASF) risk factors.
Main Methods:
- Retrospective case-control study involving 475 critically ill patients from diverse intensive care units.
- Secondary data analysis from electronic health records, including descriptive and multivariate logistic regression.
Main Results:
- Higher APACHE II scores, mortality, liver disease history, and weight loss were observed in the HAPI group.
- Risk factors for HAPIs included respiratory, renal, and cardiac failure, severe anemia, sepsis, and documented moisture.
- No association was found between unavoidable HAPIs and proposed ASF risk factors.
Conclusions:
- Clinical factors like patient acuity, organ failure, sepsis, and prior pressure injury history are linked to HAPI development.
- The study did not support a relationship between unavoidable HAPIs and proposed ASF risk factors.
- HAPI unavoidability depends on documented interventions, not solely on identified clinical risk factors.
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