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|Title:||Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study||Authors:||Labeau, Sonia O.
Benbenishty, Julie Sarah
Brett, Stephen J.
Honore, Patrick M.
Khanna, Ashish K.
Williams, Ged F.
Blot, Stijn I.
Margarit Ribas, Antoni
Honoré, Patrick M.
Telleria, Vanesa Mercado
Nogueira, Paula Cristina
Khalid Mahmood Khan, Nafees
Reyes, Amylkar Garay
|Major Field of Science:||Medical and Health Sciences||Field Category:||Health Sciences||Keywords:||Decubitus epidemiology;ICU;Morbidity;Mortality;Outcome;Pressure injury;Pressure ulcer;Risk factors||Issue Date:||Feb-2021||Source:||Intensive Care Medicine, 2021, vol. 47, pp. 160–169||Volume:||47||Start page:||160||End page:||169||Journal:||Intensive Care Medicine||Abstract:||Purpose Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score < 19, ICU stay > 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat.||URI:||https://ktisis.cut.ac.cy/handle/10488/22399||ISSN:||1432-1238||DOI:||10.1007/s00134-020-06234-9||Rights:||This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.||Type:||Article||Affiliation :||Cyprus University of Technology
HOGENT University of Applied Sciences and Arts
Cambridge University Hospitals NHS Trust
Hadassah Hebrew University Medical Center
Queen’s University Belfast
Royal Devon and Exeter NHS Foundation Trust
Imperial College London
University Hospital of Grenoble-Alpes
University of the Sunshine Coast
Queensland University of Technology and Intensive Care Services
University of Huddersfield
Ghent University Hospital
European Society of Intensive Care Medicine
CHU Brugmann University Hospital
University of Niš
Wake Forest School of Medicine
Universitat Internacional de Catalunya
Outcomes Research Consortium
King’s College London
Sunnybrook Research Institute
University of Toronto
Michael Garron Hospital
University of Michigan
Al Mafraq Hospital
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