Prognosis of stage I pressure ulcers and related factors

Abstract

The prognosis of stage I pressure ulcers cannot be predicted; therefore, nursing interventions for preventing their deterioration have not been clearly established. This study describes the clinical course of stage I pressure ulcers and prospectively investigates the factors related to their deterioration. Thirty-one stage I pressure ulcers in 30 patients in a long-term care facility were studied, and morphological changes were assessed every day until the ulcers healed or deteriorated. The physiological changes were assessed by ultrasonography and thermography. Twenty ulcers healed, and 11 deteriorated. The characteristics of deterioration were as follows: (1) double erythema; (2) non blanchable erythema across the whole area determined by glass plate compression; (3) erythema away from the tip of the bony prominence; and (4) expanding erythema on the following day. We analysed the sensitivity, specificity, positive predictive value, negative predictive value and positive likelihood ratio for the diagnostic utility of the indicators of deterioration double erythema and distance from the tip of bony prominence, which can be instantly assessed without the use of any special device. The values were 36.4%, 95.0%, 80.0%, 73.1% and 7.28, respectively. These results suggest that clinicians can predict the prognosis of stage I pressure ulcers by initial assessment and provide appropriate care based on the assessment.

Vibration Therapy Accelerates Healing of Stage I Pressure Ulcers in Older Adult Patients

“…1,20 Therefore, vibration appears to hasten the healing period of Stage I PrUs. It has been reported that 35.5% of Stage I PrUs advance to Stage II or more, 1 and it takes a longer time to heal these PrUs (Stage II, 24.8 days; Stage III, 136.8 days; Stage IV, 223.5 days).…”

“…It has been found that 35.5% of Stage I PrUs advance to Stage II or greater (National Pressure Ulcer Advisory Panel classification). 1 Therefore, it is important to provide appropriate care to prevent this progression.…”

Risk Profile Characteristics Associated With Outcomes of Hospital-Acquired Pressure Ulcers: A Retrospective Review

“…Eligible patients had HAPUs of stages I through IV, unstageable HAPUs, or SDTI HAPUs develop between November 1, 2007, and May 31,2008. Eligible patients were identified by using the pressure ulcer database, which is described in more detail later.…”

“…(Critical Care Nurse. 2011;31 [4]: [30][31][32][33][34][35][36][37][38][39][40][41][42][43] 2008, the Centers for Medicare and Medicaid Services implemented a 0% complication rate for a number of clinical diagnoses, one of which is a stage III or IV pressure ulcer acquired during a hospitalization. 12 Consequently, hospitals are not reimbursed for the care, services, or resources associated with such a HAPU.…”

Evaluation of an advanced pressure ulcer management protocol followed by trained wound, ostomy, and continence nurses: a non-randomized controlled trial

“…The advanced PU management protocol was therefore effective in preventing PU deterioration at this early stage. Sato et al 31 reported that stage I PUs took 3 weeks to develop and increase in severity. Early detection and intervention for DTI substantially reduces the time required for healing.…”