Epidemiology and outcome of pressure injuries in critically ill patients with chronic obstructive pulmonary disease: A propensity score adjusted analysis

Martín‐Loeches, Ignacio; Rose, Louise; Afonso, Elsa; Benbenishty, Julie; Blackwood, Bronagh; Boulanger, Carole; Calviño-Günther, Silvia; Chaboyer, Wendy; Coyer, Fiona; Llauradó-Serra, Mireia; Lin, Frances; Rubulotta, Francesca; Williams, Ged; Deschepper, Mieke; François, Guy; Labeau, Sonia; Blot, Stijn

doi:10.1016/j.ijnurstu.2022.104222

Cited by 13 publications

(10 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In critically ill patients, chronic obstructive pulmonary disease (COPD) has been found to be related to the development of pressure ulcers [5,[27][28][29], owing to immobility and poor perfusion. We found no relationship between COPD and risk of pressure injuries at Norton scale, similarly to the other studies conducted in NHs.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with a High-Risk Profile for Developing Pressure Injuries in Long-Term Residents of Nursing Homes

et al. 2022

View full text Add to dashboard Cite

Pressure injuries are a health problem of special concern for older adults and different scales are used to assess the risk of developing these ulcers. Aims and objective: We assessed the prevalence of residents at high risk of pressure injuries using a Norton Scale and examined the relations with the most important risk factors in a large sample of Italian nursing homes. Method: Cross-sectional cohort study in a sample of Italian long-term care nursing homes with data collected between 2018 and 2020. Results: We recruited 2604 NH residents; 1252 had Norton Scale scores, 41 (3.3%) had a diagnosis of pressure injuries, 571 (45.6%) had a Norton score ≤ 9 and 453 (36.2%) had a score between 10 and 14. The univariate model found relationship between female sex, age, dementia and cerebrovascular disease with Norton scale score ≤ 9. The significant associations were confirmed in the multivariate model with stepwise selection. Conclusion: The prevalence of NH residents at high risk of pressure injuries was very high using the Norton scale, but the percentage of residents who develop these ulcers is definitely lower. Female NH residents with advanced age, dementia and a history of cerebrovascular disease should be carefully monitored.

show abstract

Section: Discussionmentioning

confidence: 99%

Factors Associated with a High-Risk Profile for Developing Pressure Injuries in Long-Term Residents of Nursing Homes

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Each documented patient has a follow‐up period of no less than 1 year 17 . Assessment and documentation of the patient's skin condition was performed by intensive care nurses using the International Staging of Pressure Injury, which includes stages I to IV, unstageable stage, and suspected deep tissue injury 21 . ICD‐9 code 507.X and ICD‐10 code J69.X are used to identify aspiration pneumonia 22,23 …”

Section: Methodsmentioning

confidence: 99%

Braden score can independently predict 90‐day mortality in critically ill patients with dementia

Cheng,

Li,

Liang

et al. 2024

Int J Geriat Psychiatry

View full text Add to dashboard Cite

BackgroundDementia is a significant cause of death in the older population and is becoming an important public health issue as the population ages and the prevalence of dementia increases. The Braden score is one of the most commonly used clinical tools to assess the risk of skin pressure injury in patients, and some studies have reported that it may reflect the state of frailty of patients. The present study attempted to explore the association between Braden score and 90‐day mortality, pressure injury, and aspiration pneumonia in older patients with dementia in the intensive care unit (ICU).MethodsThe study involved extracting crucial data from the Medical Information Market for Intensive Care IV (MIMIC‐IV) database using Structured Query Language, with a license certificate obtained after completing the necessary training and examination available on the MIMIC‐IV website. A retrospective analysis was performed on older patients with dementia, aged 65 or older, who were first admitted to the ICU. Ninth and tenth revision International Classification of Diseases codes were used to identify patients with dementia. The primary outcome was 90‐day mortality. Cox proportional hazards models were used to determine the association between Braden score and death, and hazard ratios (HR) and 95% confidence intervals (CI) were calculated. Propensity score matching and E‐value assessments were employed for sensitivity analysis.ResultsA total of 2892 patients with a median age of approximately 85 years (interquartile range 78.74–89.59) were included, of whom 1625 were female (56.2%). Patients had a median Braden score of 14 (interquartile range 12–15) at ICU admission. Braden score at ICU admission was inversely associated with 90‐day mortality risk after adjustment for demographics, severity of illness, treatment and medications, delirium, and sepsis (adjusted HR: 0.92, 95% CI: 0.87–0.98, p = 0.006). Patients were divided into two groups with a cut‐off value of 15: high‐risk group and low‐risk group. Compared to the low‐risk group (Braden score >15), the risk of 90‐day mortality was significantly increased in the high‐risk group (Braden score ≤15) (adjusted HR: 1.52, 95% CI: 1.10–2.09, p = 0.011, E‐value: 2.01), the risk of pressure injury (adjusted OR: 2.62, 95% CI: 2.02–3.43, E‐value: 2.62) and aspiration pneumonia (adjusted OR: 2.55, 95% CI: 1.84–3.61, E‐value: 2.57) was also significantly higher.ConclusionsThe Braden score may be a quick and simple screening tool to identify the risk of adverse outcomes in critically ill older adults with dementia.

show abstract

“…Intensive care patients have different risk factors for pressure injuries (PIs) compared with patients in regular hospital wards 1,2 and are more likely to develop a hospital-acquired PI (HAPI) 3–5 . Several studies report vasopressor use, hypotension, and mechanical ventilation as prognostic factors of PI in the ICU 5–9 …”

Section: Introductionmentioning

confidence: 99%

“…[3][4][5] Several studies report vasopressor use, hypotension, and mechanical ventilation as prognostic factors of PI in the ICU. [5][6][7][8][9] Norepinephrine (or noradrenaline), a catecholamine, is an adrenergic receptor agonist with poor selectivity between αand β-adrenoceptors. Among its effects are the contraction of vascular smooth muscle and increased cardiac chronotropism and inotropism.…”

Section: Introductionmentioning

confidence: 99%

The Direct Effects of Norepinephrine Administration on Pressure Injuries in Intensive Care Patients: A Retrospective Cohort Study

Argenti,

Ishikawa,

Fadel

2023

Adv Skin Wound Care

View full text Add to dashboard Cite

OBJECTIVE To estimate the direct effects of norepinephrine administration on pressure injury (PI) incidence in intensive care patients. METHODS This is a secondary and exploratory analysis of a retrospective cohort study of intensive care patients discharged in 2017 to 2018. Observational cases only included patients who received primary PI preventive care during intensive care (N = 479). As a first-choice vasopressor drug, norepinephrine administration was approximated with days of norepinephrine. Linear path models were examined from norepinephrine administration to PI development. The identification of confounding variables and instrumental variables was grounded on directed acyclic graph theory. Direct effects were estimated with instrumental variables to overcome bias from unobserved variables. As models were re-specified with data analysis, the robustness of path identification was improved by requiring graph invariance with sample split. RESULTS Norepinephrine caused PI development from one stage to another after 4.0 to 6.3 days of administration in this cohort as a total effect (90% CI). The direct effect was estimated to advance the stage of PI at a rate of 0.140 per day of norepinephrine administered (standard error, 0.029; P < .001). The direct effect accounted for about 70% of the total effect on PI development. CONCLUSIONS Estimations with instrumental variables and structural equation modeling showed that norepinephrine administration directly and substantially affected hospital-acquired PI incidence in intensive care patients in this cohort.

show abstract

Epidemiology and outcome of pressure injuries in critically ill patients with chronic obstructive pulmonary disease: A propensity score adjusted analysis

Cited by 13 publications

References 43 publications

Factors Associated with a High-Risk Profile for Developing Pressure Injuries in Long-Term Residents of Nursing Homes

Factors Associated with a High-Risk Profile for Developing Pressure Injuries in Long-Term Residents of Nursing Homes

Braden score can independently predict 90‐day mortality in critically ill patients with dementia

The Direct Effects of Norepinephrine Administration on Pressure Injuries in Intensive Care Patients: A Retrospective Cohort Study

Contact Info

Product

Resources

About