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Incidence of Dependency-Related Skin Injury in Critical Care: A Longitudinal Study
Paula Balaguer Escutia1,2, Evelin Balaguer López2,3,4, Pablo Garcia Molina2,3,4,5
1Intensive Care Unit, Hospital Clínico Universitario de Valencia, Blasco Ibañez w/n, 46010 Valencia, Spain.
Abstract:
Background/Objectives: Dependency-related skin injuries (DRSIs) are a significant health issue that exacerbates in critically ill patients, as their clinical condition (immobility, hemodynamic instability, use of diagnostic and therapeutic devices, malnutrition, and pharmacotherapy) promotes their occurrence. The objective of this study was to analyze the incidence and characteristics of DRSIs in critically ill patients at a tertiary care hospital. Methods: An observational, descriptive, longitudinal, and prospective study was conducted in the Intensive Care Units of the Hospital Clínico Universitario de Valencia. Data were analyzed using R software (v.4.2.2). The study was approved by the institutional ethics committee, and informed consent was obtained from each patient or family member. Results: The final sample included 139 patients. The incidence of DRSIs was 33.1% (n = 46), with a total of 82 lesions recorded. The mean time to DRSI onset was 9.2 days. Pressure ulcers accounted for 76.8% (n = 63) of the injuries, of which 47.6% (n = 30) were category I. Approximately 40% of the DRSIs were associated with the use of medical devices, primarily endotracheal tubes, non-invasive ventilation, and respiratory support devices. The most frequent locations were the heels, sacrum, and nose. Conclusions: One-third of the patients admitted to the studied critical care units developed one or more DRSIs. The use of clinical devices and high-risk scores on risk assessment scales (EVARUCI and/or Braden) is associated with a greater predisposition to developing these skin injuries.
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