Pressure ulcers in ICU patients: Incidence and clinical and epidemiological features: A multicenter study in southern Brazil

Intensive Crit Care Nurs. 2017 Oct;42:55-61. doi: 10.1016/j.iccn.2017.03.009. Epub 2017 Apr 20.

Abstract

Objectives: To evaluate the incidence and risk factors of pressure ulcers (PU) in adult patients admitted to intensive care units (ICUs), as well as the outcome (including ICU and hospital mortality) of these patients.

Methods: Epidemiological cohort multicenter prospective study, evaluating patients admitted for a period of 31days (June 01 to July 01, 2015) until hospital discharge. Epidemiological and clinical data were collected daily until ICU discharge, as was the incidence of PU, either new or present on admission.

Setting: 10 general adult ICUs.

Results: We evaluated 332 patients, 52.1% male, mean age 63.1 years. The most common cause of admission was medical diseases (50.3%), and the mean APACHE II score was 14.9. A total of 45 patients (13.6%) had PU; the most common sites were sacral, calcaneal, ears, and trochanter. The incidence of PU was related to predictive factors, such as the Braden Scale and length of lack of nutrition. The presence of PU was strongly related to unfavorable outcomes, such as Mechanical Ventilation (MV) duration and ICU and hospital mortality.

Conclusions: PU incidence is related to severity of the patient's condition and predicted by Braden Scale score. The presence of PU is also related to adverse outcomes, such as MV duration and ICU and hospital mortality. It was also shown that patients with PU have a higher incidence of medical complications, such as acute renal failure, pneumonia, and the need for vasoactive drugs.

Keywords: Critical care; Epidemiology; Mortality; Pressure ulcer.

MeSH terms

  • APACHE
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Brazil / epidemiology
  • Cohort Studies
  • Female
  • Humans
  • Incidence*
  • Intensive Care Units / organization & administration
  • Intensive Care Units / statistics & numerical data
  • Male
  • Middle Aged
  • Nutritional Status
  • Pressure Ulcer / epidemiology
  • Pressure Ulcer / mortality
  • Pressure Ulcer / pathology*
  • Prospective Studies