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Pressure ulcer development in patients treated for acute ischaemic stroke
Esin Derin Cicek1, Ayper Önal Alkan2, Nihan Parasiz Yukselen3
1University of Health Sciences, Istanbul Fatih Sultan Mehmet Training and Research Hospital, Department of Radiology, Istanbul, Turkey.
Journal of Wound Care
|June 6, 2024
Summary
Patients treated for acute ischemic stroke (AIS) face a 7.4% risk of developing pressure ulcers (PUs). Mechanical thrombectomy (MT) and higher NIHSS scores increase this risk, necessitating targeted prevention strategies for at-risk individuals.
Area of Science:
- Neurology
- Vascular Medicine
- Dermatology
Background:
- Acute ischemic stroke (AIS) is a leading cause of disability, with patients often requiring intensive medical interventions.
- Pressure ulcers (PUs) are a common complication in hospitalized patients, particularly those with limited mobility and complex medical conditions.
- Understanding PU incidence and risk factors in AIS patients is crucial for improving patient outcomes and reducing healthcare burdens.
Purpose of the Study:
- To determine the incidence of pressure ulcers (PUs) in patients undergoing treatment for acute ischemic stroke (AIS).
- To identify comorbid and confounding factors associated with the development of PUs in this patient population.
- To evaluate the influence of different AIS treatment modalities on PU development.
Main Methods:
- A cohort of 242 patients treated for AIS was analyzed, categorized into three treatment groups: intravenous tissue plasminogen activator (tPA) alone, mechanical thrombectomy (MT) alone, and combined tPA and MT.
- Pressure ulcers were classified using the international classification system.
- Statistical analysis was performed to investigate factors such as age, treatment group, National Institute of Health Stroke Scale (NIHSS) scores, comorbidities, and intensive care unit (ICU) stay in relation to PU development.
Main Results:
- The overall incidence of PUs in AIS patients was 7.4%.
- Patients receiving mechanical thrombectomy (MT) (12.1%) or both tPA and MT (15.7%) had a significantly higher PU incidence compared to those receiving tPA alone (2.3%) (p=0.001).
- Higher NIHSS scores at admission (p=0.010) and longer hospitalization periods (p=0.000) were associated with PU development, while age and comorbidities were not significant factors.
Conclusions:
- Patients treated for AIS with high NIHSS scores and/or undergoing mechanical thrombectomy are at an elevated risk of developing pressure ulcers.
- Proactive and targeted preventive measures should be implemented for these high-risk AIS patients to mitigate PU development.
- Further research may explore specific interventions to reduce PU incidence in AIS patients undergoing MT.
Keywords:
International Pressure Ulcer Classification SystemNational Institutes of Health Stroke Scaleacute ischaemic strokeintravenous tissue plasminogen activator therapymechanical thrombectomypressure ulcerstrokeulcerwoundwound carewound dressingwound healingMore Related Videos
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