Related Experiment Video
Updated: Aug 1, 2025
Author Spotlight: Simulating Pediatric Cardiac Surgery Using a Neonatal Piglet Model
Published on: May 26, 2023
Risk Factors Associated With Pressure Injury in Critically Ill Children With Congenital Heart Disease
Ashlee Shields1, Jiuann-Huey Ivy Lin2
1Ashlee Shields is a programmatic nurse specialist in the cardiac intensive care unit, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania and an assistant professor, School of Nursing, Education and Human Studies, Robert Morris University, Moon Township, Pennsylvania.
Insights
Children with congenital heart disease are at high risk for hospital-acquired pressure injuries. Corticosteroid and anticoagulant use significantly increase this risk, highlighting the need for targeted prevention strategies in this vulnerable population.
Area of Science:
- Pediatric Cardiology
- Critical Care Medicine
- Nursing Research
Background:
- Children with congenital heart disease (CHD) possess unique physiological risk factors for pressure injuries (PIs) due to their abnormal heart pathophysiology.
- This population faces an elevated risk of developing PIs during hospitalization, yet research specifically addressing CHD patients and their unique risk factors remains limited.
Purpose of the Study:
- To identify and analyze the specific risk factors associated with the development of pressure injuries in pediatric patients diagnosed with congenital heart disease.
Main Methods:
- A retrospective analysis was conducted using hospital-acquired data from an urban, tertiary children's hospital.
- The study included patients admitted to the intensive care unit between 2011 and 2018 with a diagnosis of CHD.
- Chi-square and logistic regression analyses were employed to compare risk factors and predict PI acquisition probability.
Main Results:
- Out of 269 patients, 82 (30.5%) acquired pressure injuries.
- Among patients with PIs, 82% were prescribed corticosteroids and 71% received anticoagulants.
- Anticoagulant use (OR 3.25) and corticosteroid use (OR 9.98) were significant predictors of PI development (P < .001).
- A significant association was found between pressure injuries and inpatient mortality.
Conclusions:
- Corticosteroid and anticoagulant medications are identified as significant contributing factors to pressure injury development in children with congenital heart disease.
- These findings underscore the importance of vigilant monitoring and tailored preventive measures for pediatric CHD patients receiving these medications.
Background:
Children with congenital heart disease have unique risk factors associated with the pathophysiology of an abnormal heart; hence, this population is most likely at increased risk of acquiring a pressure injury during hospitalization. Few studies have included patients with congenital heart disease or examined the factors unique to these patients.
Objective:
To identify risk factors associated with pressure injury development in children with congenital heart disease.
Methods:
This retrospective study used a convenience sample from hospital-acquired data at an urban, tertiary, free-standing children's hospital. Patients were admitted to the intensive care unit between 2011 and 2018 with a diagnosis of congenital heart disease. Chi-square analysis was done to compare risk factors between patients, and logistic regression analysis was used to predict the probability that a patient would acquire a pressure injury.
Results:
Eighty-two (30.5%) of the 269 patients in this study acquired pressure injuries. Sixty-six patients with pressure injuries met the inclusion criteria for analysis; 82% of those patients had had corticosteroids prescribed, and 71% were receiving anticoagulants. The overall predictive model for acquiring a pressure injury indicated an odds ratio of 3.25 (95% CI, 1.58-6.65) with an anticoagulant and an odds ratio of 9.98 (95% CI, 4.68-21.3) with a prescribed corticosteroid (P < .001 for both factors). Inpatient mortality was significantly associated with pressure injuries.
Conclusions:
Corticosteroid and anticoagulant use were contributing factors in the development of pressure injuries in children with congenital heart disease.
Related Concept Videos
01:21Cardiac Catheterization II: Right Heart Catheterization
01:26Imbalances in Cardiac Output
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
01:27Heart Failure I: Introduction
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
01:17Pathophysiology of Heart Failure