Incidence and risk factors for pressure ulcers in the intensive care unit.
OBJECTIVE
To determine the incidence of pressure ulcers occurring at least 48 hours after admission and risk factors for pressure ulcers grade 2-4 in a long-stay surgical Intensive Care Unit (ICU) population.


BACKGROUND
The incidence of pressure ulcers in intensive care units is larger than in non-intensive environments.


METHODS
Prospective descriptive research design.


METHODS
Using pressure ulcers grade 2-4 as an outcome measure, a multivariate logistic regression analysis was used to identify the risk factors. Data were obtained on a daily basis in a surgical intensive care unit of the University Hospital Leuven between November 2003-March 2004. A total of 520 long-stay (>or= 24 hours) intensive care patients were included.


RESULTS
Cumulative incidence of pressure ulcers grade 2-4 was 20.1%. The following variables were positively associated with pressure ulcers grade 2-4: history of vascular disease, treatment with Dopamine or Dobutamine, intermittent haemodialysis (IHD) or continuous veno-venous haemofiltration (CVVH), mechanical ventilation. Also preventive measures were statistically positively associated with pressure ulcers grade 2-4: turning, floating heels, alternating mattresses, adequate prevention. The use of sedatives, body temperature above 38.5 degrees C and sitting in chair where negatively associated with pressure ulcers. Pressure ulcers are statistically associated with different risk factors and preventive measures.


CONCLUSIONS
The identified risk factors are eligible to be included in a new risk assessment scale for patients admitted to intensive care units.


CONCLUSIONS
The novel insights have implications for risk assessment for patients in intensive care units. Patients admitted to intensive care units have other risk factors for pressure ulcers which are eligible to be included in a new risk assessment scale.
Nijs
Nele
N
Department of Intensive Care Medicine, University Hospital Gasthuisberg, Catholic University of Leuven, Leuven, Belgium.
Toppets
Adinda
A
Defloor
Tom
T
Bernaerts
Kris
K
Milisen
Koen
K
Van Den Berghe
Greet
G
D000328:Adult; D000368:Aged; D004280:Dobutamine / Q000008:administration & dosage; D004298:Dopamine / Q000008:administration & dosage; D005260:Female; D006801:Humans; D015994:Incidence; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D003668:Pressure Ulcer / Q000145:classification / Q000453:epidemiology*; D011446:Prospective Studies; D006435:Renal Dialysis; D012121:Respiration, Artificial; D012307:Risk Factors
D004280:Dobutamine; D004298:Dopamine