title: [Correlation between body mass index and development of pressure ulcers in intensive care medicine].
abstract: OBJECTIVE
  This study aims to evaluate the association between body mass index (BMI), incidence and severity of pressure ulcers (PU) in patients admitted to the Intensive Care Unit (ICU), and describe the differential prognosis of patients with PU and factors that modify it.
  
  
  METHODS
  Case-control study with observation period of 15 months. We collected baseline variables, prognostic scales, therapies and clinical outcome. Univariate analysis was performed for each outcome variable between cases and controls using the appropriate hypothesis test depending on the nature of the variables. ROC curve for BMI and PU. Logistic regression with PU as dependent variable and the covariates that reached p<0.05 in the bivariate analysis. Correlation using Pearson or Spearman was made between BMI, albumin, days to diagnosis of UPP, immobilization, and PU degree. Significance level at p <0.05.
  
  
  RESULTS
  77 patients developed PU and 231 controls were chosen. The cases had higher APACHE II (p=0.043) and SAPS 3 (p=0.023), length of stay in ICU and mechanical ventilation (p<0.001). BMI≥40 was associated with UPP (p=0.024 OR=3.23 CI95% 1.17-8.93). There was a significant association between PU degree, length of stay and MV (p<0,001), but not with immobilization, dynamic support surface and death rate. Multivariate analysis found association between PU, length of MV (p=0.013, OR 1.08, CI95% 1.01-1.16) and kidney replacement therapy (p=0.013, OR 3.55 CI95% 1.31-9.64), with BMI≥40 as a confounding factor.
  
  
  CONCLUSIONS
  Length of mechanical ventilation and renal replacement therapy are risk factors for pressure ulcer development, and BMI≥40 acts as a confounding factor. PU development and its maximum degree are not associated with a worse prognosis.
authors.affiliation: Servicio de Medicina Intensiva, Hospital de Torrevieja, Alicante, España. Electronic address: gtacritico@gmail.com.
authors.forename: A I
authors.initials: AI
authors.lastname: Catalá Espinosa
authors.affiliation: Servicio de Medicina Intensiva, Hospital de Torrevieja, Alicante, España.
authors.forename: Y
authors.initials: Y
authors.lastname: Hidalgo Encinas
authors.affiliation: Servicio de Medicina Intensiva, Hospital de Torrevieja, Alicante, España.
authors.forename: T
authors.initials: T
authors.lastname: Cherednichenko
authors.affiliation: Servicio de Medicina Intensiva, Hospital de Torrevieja, Alicante, España.
authors.forename: I
authors.initials: I
authors.lastname: Flores Lucas
authors.affiliation: Servicio de Análisis Clínicos, Hospital de Torrevieja, Alicante, España.
authors.forename: R
authors.initials: R
authors.lastname: González Tamayo
authors.affiliation: Servicio de Medicina Intensiva, Hospital de Torrevieja, Alicante, España.
authors.forename: M Á
authors.initials: MÁ
authors.lastname: García-Martínez
authors.affiliation: Servicio de Medicina Intensiva, Hospital de Torrevieja, Alicante, España.
authors.forename: E
authors.initials: E
authors.lastname: Herrero-Gutiérrez
mesh_terms: D000368:Aged; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D003668:Pressure Ulcer / Q000453:epidemiology* / Q000209:etiology
keywords: Pressure ulcer, Body mass index, Risk factors, Decubitus; Úlcera por presión, Índice de masa corporal, Factores de riesgo, Decúbito