What are the risk factors for pressure injuries in intensive care? An observational retrospective study in an Italian intensive care

Submitted: 21 February 2024
Accepted: 21 June 2024
Published: 27 June 2024
Abstract Views: 2
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Objective: the present study aims to identify the risk factors for the development of pressure ulcers in an Italian intensive care unit.

Materials and Methods: a retrospective observational study was carried out through the analysis of computerized medical records of patients hospitalized in an Italian multipurpose intensive care unit (ICU) in 2019. All patients admitted to the ICU in 2019 had no pressure ulcers at the time of admission and stayed in the hospital for at least 72 hours. Patients who developed ulcers during the first 72 hours of their stay and pediatric patients were excluded.

Results: of the 256 patients analyzed, 53 (20.7%) developed at least one pressure ulcer during hospitalization in the ICU. The lesions developed on the eighth day on average.

Conclusion: the univariate analysis revealed that age, (p = 0.025) length of stay (p = 0.001), mechanical ventilation (p = 0.035), serum albumin (p = 0.006), and the Simplified Acute Physiology Score (SAPS II) (p = 0.023) were the most influential risk factors for the development of pressure ulcers in our intensive care unit.

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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.

How to Cite

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). What are the risk factors for pressure injuries in intensive care? An observational retrospective study in an Italian intensive care. Scenario® - Il Nursing Nella Sopravvivenza, 41(2). https://doi.org/10.4081/scenario.2024.584