Quali sono i fattori di rischio per le lesioni da pressione in terapia intensiva? Uno studio retrospettivo osservazionale in una terapia intensiva italiana.

Ricevuto: 21 febbraio 2024
Accettato: 21 giugno 2024
Pubblicato: 27 giugno 2024
Abstract Views: 224
PDF (English): 40
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Autori

Obiettivo: lo scopo del presente studio è identificare i fattori di rischio per lo sviluppo di ulcere da pressione in un'unità di terapia intensiva italiana.

Materiali e Metodi: è stato condotto uno studio osservazionale retrospettivo attraverso l'analisi delle cartelle cliniche informatizzate dei pazienti ricoverati in un'unità di terapia intensiva (ICU) polifunzionale italiana nel 2019. Tutti i pazienti ricoverati in terapia intensiva nel 2019 non presentavano ulcere da pressione al momento del ricovero e sono rimasti in ospedale per almeno 72 ore. Sono stati esclusi i pazienti che hanno sviluppato ulcere durante le prime 72 ore di degenza e i pazienti pediatrici.

Risultati: dei 256 pazienti analizzati, 53 (20,7%) hanno sviluppato almeno un'ulcera da pressione durante il ricovero in terapia intensiva. Le lesioni si sono sviluppate in media all'ottavo giorno.

Conclusioni: l'analisi univariata ha rivelato che l'età, (p = 0,025) la durata della degenza (p = 0,001), la ventilazione meccanica (p = 0,035), l'albumina sierica (p = 0,006) e il Simplified Acute Physiology Score (SAPS II) (p = 0,023) erano i fattori di rischio più influenti per lo sviluppo di ulcere da pressione nella nostra unità di terapia intensiva.

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Citations

National pressure ulcer advisory panel (NPIAP). Prevention and treatment of pressure ulcers: clinical practice guideline. 2019.
Padula WV, Pronovost PJ, Makic MBF, et al. Value of hospital resources for effective pressure injury prevention: a cost-effectiveness analysis. BMJ Quality Safety 2018;28:132–41.
Tirgari B, Mirshekari L, Forouzi MA. Pressure injury prevention. Adv Skin Wound Care 2018;31:1–8.
Razmus I. Factors associated with pediatric hospital-acquired pressure injuries. J Wound Ostomy Cont 2018;45:107–16.
Jaul E. Assessment and management of pressure ulcers in the elderly. Drug Aging 2010;27:311–25.
Jomar RT, Jesus RP de, Jesus MP de, at al. Incidence of pressure injury in an oncological intensive care unit. Revista Brasileira de Enfermagem 2019;72:1490–5.
Yap TL, Kennerly SM, Ly K. Pressure injury prevention: outcomes and challenges to use of resident monitoring technology in a nursing home. J Wound Ostomy Cont 2019;46:207–13.
Wåhlin I, Ek A, Lindgren M, et al. Development and validation of an icu‐specific pressure injury risk assessment scale. Scand J Caring Sci 2020;14;35.
González-Ruiz JM, Núñez-Méndez P, Balugo-Huertas S, et al. Estudio de validez de la escala de valoración actual del riesgo de desarrollar úlceras por presión en cuidados intensivos (EVARUCI). Enfermería Intensiva 2008;19:123–31.
Deschepper M, Labeau SO, Waegeman W, Blot SI. Heterogeneity hampers the identification of general pressure injury risk factors in intensive care populations: A predictive modelling analysis. Intens Crit Care Nur 2021;68;103117.
Kayser SA, VanGilder CA, Lachenbruch C. Predictors of superficial and severe hospital-acquired pressure injuries: a cross-sectional study using the international pressure ulcer prevalence survey. Int J Nurs Stud 2019;89:46–52.
Pachá HHP, Faria JIL, Oliveira KA de, Beccaria LM. Pressure ulcer in intensive care units: a case-control study. Revista Brasileira Enfermagem 2018;71:3027–34.
Tayyib N, Coyer F, Lewis P. Saudi Arabian adult intensive care unit pressure ulcer incidence and risk factors: a prospective cohort study. Int Wound J 2015;13:912–9.
Amini M, Mansouri F, Vafaee K, et al. Factors affecting the incidence and prevalence of pressure ulcers in COVID‐19 patients admitted with a Braden scale below 14 in the intensive care unit: retrospective cohort study. Int Wound J 2022;19:2039–54
Cox J. Pressure injury risk factors in adult critical care patients: a review of the literature. Ostomy Wound Manag 2017;63:30–43
Lucchini A, Elli S, Bianchi F, et al. Incidenza e fattori di rischio associate allo sviluppo di lesioni da pressione in una terapia intensiva generale italiana [Incidence and risk factors associated with the development of pressure ulcers in an Italian general intensive care unit]. Assist Inferm Ric 2018;37:181-8.
McEvoy N, Patton D, Avsar P, et al. Effects of vasopressor agents on the development of pressure ulcers in critically ill patients: a systematic review. J Wound Care 2022;31:266–77.
Serpa LF, Ortiz MM, Lima AC, et al. Incidence of hospital‐acquired pressure injury: A cohort study of adults admitted to public and private hospitals in Sao Paulo, Brazil. Wound Repair Regen 2020;29:79–86.
Kim P, Aribindi VK, Shui AM, et al. Risk factors for hospital-acquired pressure injury in adult critical care patients. Am J Crit Care 2022;31:42–50.
Hyun S, Li X, Vermillion B, et al. Body mass index and pressure ulcers: improved predictability of pressure ulcers in intensive care patients. Am J Crit Care 2014;23:494–501.
Sayan HE, Girgin NK, Asan A. Prevalence of pressure ulcers in hospitalized adult patients in Bursa, Turkey: a multicentre, point prevalence study. J Eval Clin Pract 2020;26:1669–76.
Erbay Dallı Ö, Ceylan İ, Kelebek Girgin N. Incidence, characteristics and risk factors of medical device-related pressure injuries: An observational cohort study. Intensive Crit Care Nurs 2022;69:103180.
Martin-Loeches I, Rose L, Afonso E, et al. Epidemiology and outcome of pressure injuries in critically ill patients with chronic obstructive pulmonary disease: A propensity score adjusted analysis. Int J Nurs Stud 2022;129:104222.
Cox J, Schallom M, Jung C. Identifying risk factors for pressure injury in adult critical care patients. Am J Crit Care 2020;29:204–13.
El-Marsi J, Zein-El-Dine S, Zein B, et al. Predictors of pressure injuries in a critical care unit in Lebanon. J Wound Ostomy Cont 2018;45:131–6.
Higgins J, Casey S, Taylor E, et al. Comparing the Braden and Jackson/Cubbin pressure injury risk scales in trauma-surgery ICU patients. Crit Care Nurse 2020;40:52–61.
Smit I, Harrison L, Letzkus L, Quatrara B. What factors are associated with the development of pressure ulcers in a medical intensive care unit? Dimens Crit Care Nurs 2016;35:37–41.
Labeau SO, Afonso E, Benbenishty J, et al. Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the decubitus study. Intens Care Med 2020;47:160–9.
Nowicki JL, Mullany D, Spooner A, et al. Are pressure injuries related to skin failure in critically ill patients? Aust Crit Care 2018;31:257–63.
Coyer F, Chaboyer W, Lin F, et al. Pressure injury prevalence in Australian intensive care units: a secondary analysis. Aust Crit Care 2022;35:701-8.
Kirkland-Kyhn H, Teleten O, Wilson M. A retrospective, descriptive, comparative study to identify patient variables that contribute to the development of deep tissue injury among patients in intensive care units. Ostomy Wound Manag 2017;63:42–7.
González-Méndez MI, Lima-Serrano M, Martín-Castaño C, et al. Incidence and risk factors associated with the development of pressure ulcers in an intensive care unit. J Clin Nurs 2017;27:1028–37.
Lin FF, Liu Y, Wu Z, et al. Pressure injury prevalence and risk factors in Chinese adult intensive care units: a multi‐centre prospective point prevalence study. Int Wound J 2022;19:493-506.
Ji Seon Shine, Soo Jin Kim, Ji Hyun Lee, Yu M. Factors predicting the interface pressure related to pressure injury in intensive care unit patients. J Korean Acad Nurs 2017;47:794–4.
Ülker Efteli E, Yapucu Günes Ü. A prospective, descriptive study of risk factors related to pressure ulcer development among patients in intensive care units. Ostomy Wound Manag 2013;59:22–7.

Come citare

Pazzini, A., Biselli, B., Vannini, C., Fabbri, E., Falabella, F., Santandrea, M. G., Marziliano, M., Gagliardi, N., Di Giandomenico, S., Scotto di Minico, S., & Di Biasi, V. (2024). Quali sono i fattori di rischio per le lesioni da pressione in terapia intensiva? Uno studio retrospettivo osservazionale in una terapia intensiva italiana. Scenario® - Il Nursing Nella Sopravvivenza, 41(2). https://doi.org/10.4081/scenario.2024.584