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Sepsis episodes caused by pressure injuries in critical illness: a retrospective observational cohort study
Pınar Küçükdemirci Kaya1, Murad Kaya1, Nermin Kelebek Girgin1
1Bursa Uludag University Faculty of Medicine, Bursa, Turkey.
Background:
Critically-ill patients (CIPs) with pressure injuries (PIs) may develop bloodstream infections (BSIs).
Purpose:
To identify predisposing factors and discuss diagnosis and management of sepsis-related PIs in CIPs.
Methods:
The records of CIPs in the intensive care unit (ICU) between January 1, 2014, and January 1, 2020, with PI with sepsis-diagnoses and with different site cultures that were positive concurrent with bloodstream-cultures were retrospectively reviewed.
Results:
Ninety-one sepsis episodes were included in the study. Low albumin level (U = 382.00, P = .006), renal failure (odds ratio [OR], 0.108 [95% CI, 0.015-0.783]; P = .025), and length of ICU stay (U = 130.00, P < .001) were identified as risk factors of BSIs due to PIs. The probability of BSI during a sepsis episode was lower in CIPs with PIs with higher C-reactive protein levels (U = 233.00, P < .001) and whose injury resulted from trauma or surgery (OR, 0.101 [95% CI, 0.016-0.626]; P = .014). The mortality was higher in CIPs with PI-induced BSIs (OR, 0.051 [95% CI, 0.008-0.309]; P = .001).
Conclusions:
Pressure injury-induced sepsis was associated with a high risk of 28-day mortality. The findings suggest that CIPs with PI are at increased risk of BSIs if they have low albumin levels, renal-failure, and prolonged ICU stay during sepsis episodes.
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