Pressure ulcer incidence and risk factors in ventilated intensive care patients.
OBJECTIVE
The aim of this study was to determine the incidence of pressure ulcers (PUs) in ventilated patients in all intensive care units (ICUs) in Granada (Spain) and identify risk factors for their development.


METHODS
A prospective cohort study in 9 medical-surgical ICUs was conducted. Two hundred ninety-nine patients with more than 24 hours on mechanical ventilation (MV) were enrolled during 2 periods in a 5-month study. Pressure ulcers of patients were measured according to the European Pressure Ulcer Advisory Panel.


RESULTS
Of the 299 patients initially enrolled, 47 (16%) developed PUs of at least grade II severity. The incidence density of PUs was 13.4 cases per 1000 patient-days of ICU stay and 19.6 cases per 1000 patient-days on MV. Logistic regression identified first-day respiratory sequential organ failure assessment (odds ratio [OR], 1.56; 95% confidence interval [CI], 1.026-2.360; P = .037), fourth-day cardiovascular sequential organ failure assessment (OR, 1.33; 95% CI, 1.066-1.664; P = .012), age (OR, 1.042; 95% CI, 1.013-1.072; P = .004), winter period (OR, 4.60; 95% CI, 1.99-10.59; P < .001), and length of MV before PUs (OR, 1.042; 95% CI, 1.005-1.080; P = .024) as significant independent predictors of PU development.


CONCLUSIONS
Among other factors previously known in ventilated patients, duration of MV and winter period were identified as risk factors for PUs.
Manzano
Francisco
F
Intensive Care Unit, Hospital General (University Hospital Virgen de las Nieves), Granada, Spain. fmanzano@mailpersonal.com
Navarro
Maria José
MJ
Roldán
Delphine
D
Moral
Maria Angeles
MA
Leyva
Isabel
I
Guerrero
Carmen
C
Sanchez
Maria Angustias
MA
Colmenero
Manuel
M
Fernández-Mondejar
Enrique
E
D000328:Adult; D000368:Aged; D003422:Critical Care; D005260:Female; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D003668:Pressure Ulcer / Q000453:epidemiology* / Q000209:etiology; D011446:Prospective Studies; D012307:Risk Factors; D012621:Seasons; D012720:Severity of Illness Index; D013030:Spain; D013997:Time Factors; D012122:Ventilators, Mechanical