Hospital-acquired pressure ulcers and risk of hospital mortality in intensive care patients on mechanical ventilation.
OBJECTIVE
Pressure ulcers (PUs) are a common and serious complication in critically ill patients. The aim of this study was to evaluate the relationship between the development of a PU and hospital mortality in patients requiring mechanical ventilation (MV) in an intensive care unit (ICU).


METHODS
A prospective cohort study was performed over two years in patients requiring MV for ≥ 24 hours in a medical-surgical ICU. Primary outcome measure was hospital mortality and main independent variable was the development of a PU grade ≥ II. Hazard ratios (HRs) were calculated using a Cox model with time-dependent covariates.


RESULTS
Out of 563 patients in the study, 110 (19.5%) developed a PU. Overall hospital mortality was 48.7%. In the adjusted multivariate model, PU onset was a significant independent predictor of mortality (adjusted HR, 1.28; 95% confidence interval, 1.003-1.65; P = 0.047). The model also included the Acute Physiology and Chronic Health Evaluation II score, total Sequential Organ Failure Assessment on day 3, hepatic cirrhosis and medical admission.


CONCLUSIONS
Within the limitations of a single-centre approach, PU development appears to be associated with an increase in mortality among patients requiring MV for 24 hours or longer.
Intensive Care Unit, Hospital Universitario Virgen de las Nieves, Granada, Spain.
Francisco
F
Manzano
Ana M
AM
Pérez-Pérez
Susana
S
Martínez-Ruiz
Cristina
C
Garrido-Colmenero
Delphine
D
Roldan
María Del Mar
Mdel M
Jiménez-Quintana
Emilio
E
Sánchez-Cantalejo
Manuel
M
Colmenero
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D017052:Hospital Mortality; D006785:Hospitals, University; D006801:Humans; D007362:Intensive Care Units; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D003668:Pressure Ulcer; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012121:Respiration, Artificial; D018570:Risk Assessment; D013030:Spain
cohort studies; critically ill; intensive care unit; mechanical ventilation; mortality; outcome studies; pressure ulcers; risk factor