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Comparing Risk Profiles in Critical Care Patients With Stage 2 and Deep Tissue Pressure Injuries: Exploratory

Jenny Alderden1, Linda Amoafo1, Yue Zhang1

  • 1University of Utah, Salt Lake City, UT, United States.

JMIR Dermatology
|August 26, 2023
PubMed
Summary
This summary is machine-generated.

Hospital-acquired pressure injuries (HAPrIs) in intensive care units (ICUs) have distinct risk factors. Stage 2 HAPrIs are more common on bony prominences, while deep tissue injuries (DTIs) are linked to low blood pressure and vasopressor use.

Keywords:
EHRscritical careelectronic health recordshospital-acquired pressure injuryintensive carepressure injurypressure ulcertissue damage

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Area of Science:

  • Critical care medicine
  • Wound healing research
  • Patient safety initiatives

Background:

  • Hospital-acquired pressure injuries (HAPrIs) are a significant concern in critical care.
  • Stage 2 and deep tissue injury (DTI) are common HAPrI classifications in intensive care units (ICUs).
  • Understanding the distinct etiologies of stage 2 HAPrIs and DTIs is crucial for developing targeted prevention strategies.

Purpose of the Study:

  • To compare the risk profiles of intensive care unit (ICU) patients who developed stage 2 pressure injuries versus deep tissue injuries (DTIs).

Main Methods:

  • Retrospective cohort study analyzing electronic health records of ICU patients.
  • Comparison of demographic characteristics, Braden Scale scores, hemodynamic data, and comorbidities.
  • Logistic regression modeling with LASSO to identify critical risk factors differentiating stage 2 and DTI development.

Main Results:

  • Stage 2 HAPrIs were more frequently located on bony prominences compared to DTIs.
  • Patients with stage 2 HAPrIs had a longer ICU length of stay.
  • DTIs were associated with lower diastolic blood pressure and increased likelihood of receiving epinephrine infusions.

Conclusions:

  • Stage 2 HAPrIs and DTIs exhibit different risk factors and anatomical patterns.
  • Deep tissue injuries (DTIs) are more strongly associated with hemodynamic instability (low diastolic blood pressure) and vasopressor use (epinephrine).
  • Stage 2 HAPrIs are more likely to occur on bony prominences, whereas DTIs are more common on soft tissues like the buttocks.