PMID- 18186374
OWN - NLM
STAT- MEDLINE
DCOM- 20080205
LR  - 20220318
IS  - 0003-1348 (Print)
IS  - 0003-1348 (Linking)
VI  - 73
IP  - 12
DP  - 2007 Dec
TI  - Risk factors for pressure ulcer development in a best practice surgical intensive 
      care unit.
PG  - 1215-7
AB  - We describe the incidence of and define risk factors for pressure ulcers (PU) in 
      the surgical intensive care unit (ICU). Twelve months of data were collected on 
      all patients admitted to the intensivist-run surgical ICU of a university 
      hospital. PU patients were those who developed a new stage II or greater lesion 
      during or after a surgical ICU stay as identified in Project Impact, ICD9 
      discharge, or ICU complications databases. Patients were nursed in 
      pressure-relieving beds with nutrition initiated by 72 hours. Chi2, t test, and 
      logistic regression statistics were used. Three percent (25/820) developed PU. 
      Age, ICU length of stay, Acute Physiology and Chronic Health Evaluation Score 
      (APACHE), and gender were not different between those with and without PU. 
      Patients with PU had a higher blood urea nitrogen/creatinine (30.5/2.2 mg/dL vs 
      22.0/1.6 mg/dL) and were more frequently vascular patients (28 vs 14.1%), 
      diabetics (40 vs 17.2%), paraplegics (8 vs 0.2%) (all P < 0.01), and patients on 
      pressors (28.0 vs 11.8%, P < 0.02). Multivariate analysis revealed that diabetes 
      (odds ratio [OR] 2.7, 95%, confidence interval [CI] 1.1-6.4), spinal cord injury 
      (OR 16.8, 95%, CI 1.5-183), age > 60 years (OR 2.9, 95%, CI 1.2-7.1), and a 
      creatinine >3 mg/dL (OR 3.7, 95%, CI 1.2-9.3) were independent predictors of PU. 
      Despite universal use of specialty beds and early nutrition, pressure ulcers 
      developed in 3 per cent. Independent risk factors include age greater than 60 
      years, diabetes, spinal cord injury, and renal insufficiency. Additional 
      modalities, such as aggressive early mobilization, might be warranted in this 
      cohort.
FAU - Frankel, Heidi
AU  - Frankel H
AD  - Division of Burn/Trauma/Critical Care, Department of Surgery, University of Texas 
      Southwestern Medical Center, Dallas, USA. heidi.frankel@utsouthwestern.edu
FAU - Sperry, Jason
AU  - Sperry J
FAU - Kaplan, Lewis
AU  - Kaplan L
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am Surg
JT  - The American surgeon
JID - 0370522
SB  - IM
MH  - APACHE
MH  - Aged
MH  - Beds
MH  - Cohort Studies
MH  - *Critical Care
MH  - Female
MH  - Humans
MH  - Length of Stay
MH  - Male
MH  - Middle Aged
MH  - Nutrition Therapy
MH  - *Postoperative Complications
MH  - Pressure Ulcer/*etiology/therapy
MH  - Retrospective Studies
MH  - Risk Factors
EDAT- 2008/01/12 09:00
MHDA- 2008/02/06 09:00
CRDT- 2008/01/12 09:00
PHST- 2008/01/12 09:00 [pubmed]
PHST- 2008/02/06 09:00 [medline]
PHST- 2008/01/12 09:00 [entrez]
PST - ppublish
SO  - Am Surg. 2007 Dec;73(12):1215-7.