Incidence of pressure ulcers in a neurologic intensive care unit

Crit Care Med. 2001 Feb;29(2):283-90. doi: 10.1097/00003246-200102000-00011.


Objectives: To determine the risk factors for pressure ulceration in an intensive care setting, to evaluate the Braden scale as a predictor of pressure ulcer risk in critically ill patients, and to determine whether pressure ulcers are likely to occur early in the hospital stay.

Design: Cohort study of patients with no preexisting ulcers with a 3-month enrollment period.

Setting: The neurologic intensive care unit and the neurologic intermediate unit at a primary care/referral hospital with a level I trauma center.

Patients: A total of 186 patients entered the study.

Intervention: Within 12 hrs of admittance, initial assessment, photographs, and Braden score were completed. Patients were re-examined every 4 days or at discharge from the unit, whichever came first.

Main outcome measures: Determining risk factors for pressure ulcers, performing detailed statistical analyses, and testing the usefulness of the Braden score as a predictor of pressure ulcer risk.

Results: Twenty-three of 186 patients developed at least one pressure ulcer (incidence = 12.4%) after an average stay of 6.4 days. The Braden scale, which measures six characteristics of skin condition and patient status, proved to be a primary predictor of ulcer development. No ulcers developed in the 69 patients whose Braden score was 16 or higher. The likelihood of developing a pressure sore was predicted mathematically from the Braden score. However, being underweight was a significant and distinct factor in pressure ulcer development.

Conclusions: Pressure ulcers may develop within the first week of hospitalization in the intensive care unit. Patients at risk have Braden scores of < or = 16 and are more likely to be underweight. These results suggest that aggressive preventive care should be focused on those patients with Braden scores of < or = 13 and/or a low body mass index at admission.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • Female
  • Health Status
  • Humans
  • Incidence
  • Intensive Care Units*
  • Length of Stay / statistics & numerical data
  • Likelihood Functions
  • Male
  • Middle Aged
  • Nursing Assessment / methods
  • Nursing Assessment / standards*
  • Nursing Evaluation Research
  • Nutritional Status
  • Predictive Value of Tests
  • Pressure Ulcer / classification
  • Pressure Ulcer / epidemiology*
  • Pressure Ulcer / etiology*
  • Pressure Ulcer / nursing
  • Pressure Ulcer / prevention & control
  • Prospective Studies
  • Risk Factors
  • Sex Distribution
  • Time Factors