Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Mat Nor, Mohd Basri and Labeau, Sonia and Afonso, Elsa and Benbenishty, Julie and Blackwood, Bronagh and Boulanger, Carole (2020) Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study. Intensive Care Medicine, 47 (2). pp. 160-169. ISSN 0342-4642 E-ISSN 1432-1238

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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 fac‑ tors 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-efects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICUacquired. Overall prevalence was 26.6% (95% confdence 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 afected. Factors independently associated with ICU-acquired pres‑ sure injuries were older age, male sex, being underweight, emergency surgery, higher Simplifed Acute Physiology Score II, Braden score <19, ICU stay >3 days, comorbidities (chronic obstructive pulmonary disease, immunodefciency), organ sup‑ port (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identifed 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.

Item Type:	Article (other)
Additional Information:	Authors have been truncated with only the first 5 names plus one IIUM author only because of too many names involved. Full author list is available in the supplemental materials from the publisher's website - sbs 25.2.2022
Uncontrolled Keywords:	Decubitus epidemiology, ICU, Pressure injury, Pressure ulcer, Outcome, Risk factors, Morbidity, Mortality
Subjects:	R Medicine > R Medicine (General) R Medicine > RC Internal medicine > RC82 Medical Emergencies, Critical Care, Intensive Care, First Aid
Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button):	Kulliyyah of Medicine > Department of Anaesthesiology & Intensive Care
Depositing User:	Dr. Mohd Basri Mat Nor
Date Deposited:	25 Feb 2022 16:42
Last Modified:	25 Feb 2022 16:42
URI:	http://irep.iium.edu.my/id/eprint/91110

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