title: [Pressure ulcers in intensive care: assessment of risk and prevention measures].
abstract: Pressure ulcers (PU) are associated to greater patient morbidity and mortality. Thus, all prevention measures are very important. In order to establish the appropriate care early, the first measure is the identification of patients at risk of developing PU, using specific scales.
  
  
  OBJECTIVE
  1) to assess the risk of developing PU in the patients admitted in an Intensive Care Unit (ICU), using the Waterlow scale; 2) to identify patients with PU and to analyse the possible relationship between them and the measured risk; 3) to analyse the preventive care received by patients for its prevention.
  
  
  METHODS
  This descriptive study analysed the risk of developing PU in 91 critical patients with a stay greater than 3 days. To measure the risk the Waterlow scale (modified by Weststrate in 1998), that included 14 risk factors, was used. Sociodemographic data, cause of admission, patients with PU, its location and grade and care applied were also collected.
  
  
  RESULTS
  Risk grade obtained on the Waterlow scale was: without risk (< 10 points) in 8 patients, 23 with risk (10-14 points), 29 with high risk (15-19 points) and 31 had very high risk (20 points). Thirteen patients had ulcer, in 10 of them it was present on admission. Their score obtained on the scale was risk in 2 patients, high risk in 5 and very high risk in the remaining 6. A statistically significant difference was found between the mean score of risk of the 13 patients who had ulcer and the remaining sample (21.85-16.83; p = 0.005). When the risk factors included in the scale and its relationship with the presence of ulcer were analysed, statistically significant difference was only found in the "heart failure" factor (vasoconstrictor treatment), p = 0.045. No association was found between age, gender, diagnosis and presence of ulcer. Regarding the daily care applied to patients, the following results were obtained: skin hydration and hygiene were done in 100% of the patients, patient repositioning were done every 2 hours or more frequently in 80% of the patients, every 3 hours in 10% and in the remaining 10%, with a frequency greater than 4 hours. Heel protection was applied in 57% of the patients and special mattress was used in 54%.
  
  
  CONCLUSIONS
  Most of the studied patients had high risk of developing PU. The patients who had an ulcer were at risk of developing it. The low incidence of ulcers obtained in this study allows us to consider appropriate the protocol of care.
authors.affiliation: Unidad de Cuidados Intensivos, Clínica Universitaria, Universidad de Navarra, Pamplona, Spain. eaizpi@yahoo.es
authors.forename: Eva
authors.initials: E
authors.lastname: Aizpitarte Pegenaute
authors.forename: Ana
authors.initials: A
authors.lastname: García de Galdiano Fernández
authors.forename: Nerea
authors.initials: N
authors.lastname: Zugazagoitia Ciarrusta
authors.forename: María Angeles
authors.initials: MA
authors.lastname: Margall Coscojuela
authors.forename: María Carmen
authors.initials: MC
authors.lastname: Asiain Erro
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care / Q000379:methods*; D003953:Diagnosis-Related Groups; D004198:Disease Susceptibility; D005260:Female; D006785:Hospitals, University; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D003668:Pressure Ulcer / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology