Prevalence of pressure injuries among critically ill patients and factors associated with their occurrence in the intensive care unit: The PRESSURE study

Jacq, Gwenaëlle; Valéra, Sabine; Muller, Grégoire; Decormeille, Guillaume; Youssoufa, Atika; Poiroux, Laurent; Allaert, F. A.; Barrois, B.; Rigaudier, Florian; Ferreira, Paulo H.; Huard, David; Heming, Nicholas; Aïssaoui, Nadia; Barbar, Saber; Boissier, Florence; Grimaldi, David; Hraiech, Sami; Lascarrou, Jean Baptiste; Piton, Gaël; Michel, P.

doi:10.1016/j.aucc.2020.12.001

Cited by 27 publications

(30 citation statements)

References 28 publications

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“…In terms of hospital-acquired pressure injury category counts, we found a much smaller propor- (Cox et al, 2022). A large proportion (40.8%) of severe pressure injuries (Stages III and IV) was also reported in the French intensive care prevalence study (Jacq et al, 2021), although this may have included non-intensive care-acquired pressure injuries, and a small Brazilian study in which a third were Stages III and IV (Rodrigues et al, 2021).…”

Section: Discussionmentioning

confidence: 46%

“…Since publication of the 2014 international guideline (National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel, & Pan Pacific Pressure Injury Alliance, 2014), it has been recommended that mucosal pressure injuries are included in prevalence and incidence studies. Whilst we were unable to report devicerelated pressure injury prevalence, we recommend that this should be investigated in all future pressure injury prevalence or incidence studies in intensive care, especially given the fact that most intensive care patients require multiple devices, and a large proportion of intensive care-associated pressure injury is related to their use (Coyer et al, 2014;Coyer, Cook, Doubrovsky, Campbell, et al, 2022;Fulbrook, Lovegrove, Miles, & Isaqi, 2022;Jacq et al, 2021;Mehta et al, 2019). An international consensus document offers a strategic approach to devicerelated pressure injury prevention (Gefen et al, 2022) comparison of standardised hospital-acquired pressure injury prevalence estimates to an external benchmark or between hospitals; assuming all patients were hypothetically treated at each hospital (Jones & Spiegelhalter, 2011).…”

Section: Discussionmentioning

confidence: 99%

“…2017, across 86 participating intensive care units, overall prevalence of 18.7% (95% CI 16.6-21.0) was reported (Jacq et al, 2021), although it is not clear whether all of these injuries were hospitalacquired. However, when patients with pressure injuries on admission to intensive care were excluded, the prevalence of intensive care-acquired pressure injury was 12.5% (95% CI 10.6-14.3).…”

Section: What Does This Paper Contribute To the Wider Global Community?mentioning

confidence: 99%

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State‐wide prevalence of pressure injury in intensive care versus acute general patients: A five‐year analysis

Fulbrook

Lovegrove

Hay

et al. 2023

Journal of Clinical Nursing

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Aim:The aim of this study was to analyse prevalence of pressure injury in intensive care versus non-intensive care patients.Background: Hospital-acquired pressure injury is an enduring problem. Intensive care patients are more susceptible due to multiple risk factors. Several studies have indicated that intensive care patients are more likely than general patients to develop pressure injuries.Design: Secondary data analysis.Methods: Eighteen general hospitals with intensive care units were included. The sample included all consenting patients. Logistic regression modelling was used to derive prevalence and effect estimates. STROBE reporting guidelines were followed. Results:The sample comprised 15,678 patients; 611 were in intensive care. The crude prevalence estimate of hospital-acquired pressure injury was 9.6% in intensive care and 2.1% in non-intensive care patients. The ≥Stage II hospital-acquired prevalence estimate in was 8.6% intensive care and 1.2% in non-intensive care patients.Intensive care patients were at markedly increased risk of hospital-acquired pressure injury compared with non-intensive care patients, with risk persisting after adjusting for pressure injury risk score. Risk of ≥ Stage II hospital-acquired pressure injury was further elevated. Intensive care patients had a higher pressure injury risk level and developed a greater proportion of severe hospital-acquired pressure injuries than non-intensive care patients. In intensive care, most hospital-acquired pressure injuries were found on the sacrum/coccyx and heels.Conclusions: There were significant differences between the hospital-acquired pressure injury prevalence of intensive care versus non-intensive care patients, which is consistent with previous studies. Overall, the prevalence of hospital-acquired pressure injury in intensive care is relatively high, indicating that their prevention should remain a high priority within the intensive care setting.

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Section: Discussionmentioning

confidence: 46%

Section: Discussionmentioning

confidence: 99%

Section: What Does This Paper Contribute To the Wider Global Community?mentioning

confidence: 99%

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State‐wide prevalence of pressure injury in intensive care versus acute general patients: A five‐year analysis

Fulbrook

Lovegrove

Hay

et al. 2023

Journal of Clinical Nursing

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“…That is to say, the scheme will form a vicious circle between disorders, thereby correcting the disordered physiological environment [29][30][31] . At the same time, the use of DCR can minimize crystalloid infusion, thereby reducing the risk and mortality of traumatic coagulopathy [5,6,32] .…”

Section: Table 1: Basic Information Of Drugsmentioning

confidence: 99%

Effects of Damage Control Resuscitation Combined with Alanyl Glutamine on Complications and Survival in Sufferers with Severe Multiple Trauma

Chen¹,

He²,

Luo³

et al. 2022

IJPS

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To explore the clinical value of damage control resuscitation combined with alanyl glutamine in the treatment of severe multiple trauma sufferers is the main objective of the study. A total of 120 sufferers with injury severity score≥16 points of severe multiple trauma who were admitted to our hospital from November 2019 to February 2022 were selected and separated into blank group and intervention group (group J and group M) according to random grouping method with 40 people in each group. The general information, clinical indicators, thromboelastography indicators, complications and survival rate of the sufferers were recorded. The operation time, coagulation function time, hospitalization time, body temperature recovery time, prothrombin time, activated partial thromboplastin time, blood loss, total fluid input and mortality of the study subjects were statistically significant. The coagulation indexes of the three groups of research subjects before blood transfusion were not statistically significant and the coagulation indexes of the intervention group (J and M groups) after blood transfusion were statistically significant compared with the blank group. Damage control resuscitation combined with alanyl glutamine significantly reduces complication rates in sufferers with severe polytrauma, thereby improving the survival rate of sufferers after surgery.

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“…Pressure injuries, also known as “pressure ulcers,” are lesions of the skin or mucosa and underlying tissues that are caused by external pressure [ 1 , 2 ]. Patients in the intensive care unit (ICU) are known to have a high risk for developing pressure injuries [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Neuromuscular blocking agents and opioids are major risk factors for developing pressure injuries in patients in the intensive care unit

Lee

Hong

et al. 2022

Korean J Intern Med

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Background/Aims: Patients in the intensive care unit (ICU) are at high risk for developing pressure injuries, which can cause severe complications and even increase the mortality risk. Therefore, prevention of pressure injuries is most important. In this study, we investigated the risk factors of pressure injury development in patients admitted to the ICU. Methods: We retrospectively analyzed patients ages > 18 years admitted to the medical ICU in a tertiary hospital between January and December 2019. We collected patient baseline characteristics, medications received, mechanical ventilation or hemodialysis use, laboratory findings, and date of pressure injury onset and characteristics. Results: We analyzed 666 patients who did not have pressure injuries at ICU admission. Pressure injuries developed in 102 patients (15%). The risk of pressure injury development increased as the administration days for neuromuscular blocking agents (NMBAs; odds ratio [OR], 1.138; p = 0.019) and opioids (OR, 1.084; p = 0.028) increased, and if the patient had problem with friction and shear (OR, 2.203; p = 0.011). Conclusions:The prolonged use of NMBAs and opioids can increase the risk of pressure injury development. Because these medications are associated with immobilization, using both should be minimized and patient early mobilization should be promoted. Among the Braden subscales, "friction and shear" was associated with the development of pressure injuries in ICU patients.

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Prevalence of pressure injuries among critically ill patients and factors associated with their occurrence in the intensive care unit: The PRESSURE study

Cited by 27 publications

References 28 publications

State‐wide prevalence of pressure injury in intensive care versus acute general patients: A five‐year analysis

State‐wide prevalence of pressure injury in intensive care versus acute general patients: A five‐year analysis

Effects of Damage Control Resuscitation Combined with Alanyl Glutamine on Complications and Survival in Sufferers with Severe Multiple Trauma

Neuromuscular blocking agents and opioids are major risk factors for developing pressure injuries in patients in the intensive care unit

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