title: A Model of Pressure, Oxygenation, and Perfusion Risk Factors for Pressure Ulcers in the Intensive Care Unit.
abstract: BACKGROUND
  Although most intensive care patients are at risk for pressure ulcers, not all experience such ulcers.
  
  
  OBJECTIVE
  To examine a model of variables related to extrinsic and intrinsic pressure on skin and underlying tissues, oxygenation, perfusion, and baseline comorbid conditions to identify risk factors associated with pressure ulcers in critically ill adults.
  
  
  METHODS
  A retrospective chart review was conducted on patients identified by weekly rounds from January 2010 through October 2010 to determine the prevalence of pressure ulcers. Variables were analyzed via bivariate analysis and logistic regression for unit-acquired pressure ulcers.
  
  
  RESULTS
  Data on 345 patients with 436 intensive care admissions were reviewed. Variables were significant in each model category at P < .05. In the regression analysis of first admission only (n = 306), the model was significant (P < .001) and yielded correct classification of 86.3% of patients. For all intensive care admissions (n = 391), the model was significant (P < .001) and yielded correct classification of 83.9% of patients. In both models, 4 of the same variables were significant: any transport off the unit, number of days to bed change, systolic blood pressure less than 90 mm Hg, and use of more than 1 vasopressor. History of pulmonary disease and presence of a feeding tube were also significant in regression analyses.
  
  
  CONCLUSIONS
  Several variables within the model of pressure, oxygenation, and perfusion were significantly associated with development of pressure ulcers.
authors.affiliation: Deborah Bly is a staff nurse in the medical intensive care unit, Marilyn Schallom is a clinical nurse specialist and research scientist in the Department of Research for Patient Care Services, Carrie Sona is a clinical nurse specialist in the surgical intensive care unit, and Dean Klinkenberg is lead statistical analyst in the Department of Research for Patient Care Services, Barnes-Jewish Hospital at Washington University, St Louis, Missouri. dcb9106@bjc.org.
authors.forename: Deborah
authors.initials: D
authors.lastname: Bly
authors.affiliation: Deborah Bly is a staff nurse in the medical intensive care unit, Marilyn Schallom is a clinical nurse specialist and research scientist in the Department of Research for Patient Care Services, Carrie Sona is a clinical nurse specialist in the surgical intensive care unit, and Dean Klinkenberg is lead statistical analyst in the Department of Research for Patient Care Services, Barnes-Jewish Hospital at Washington University, St Louis, Missouri.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Schallom
authors.affiliation: Deborah Bly is a staff nurse in the medical intensive care unit, Marilyn Schallom is a clinical nurse specialist and research scientist in the Department of Research for Patient Care Services, Carrie Sona is a clinical nurse specialist in the surgical intensive care unit, and Dean Klinkenberg is lead statistical analyst in the Department of Research for Patient Care Services, Barnes-Jewish Hospital at Washington University, St Louis, Missouri.
authors.forename: Carrie
authors.initials: C
authors.lastname: Sona
authors.affiliation: Deborah Bly is a staff nurse in the medical intensive care unit, Marilyn Schallom is a clinical nurse specialist and research scientist in the Department of Research for Patient Care Services, Carrie Sona is a clinical nurse specialist in the surgical intensive care unit, and Dean Klinkenberg is lead statistical analyst in the Department of Research for Patient Care Services, Barnes-Jewish Hospital at Washington University, St Louis, Missouri.
authors.forename: Dean
authors.initials: D
authors.lastname: Klinkenberg
mesh_terms: D001794:Blood Pressure; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D010100:Oxygen / Q000378:metabolism*; D003668:Pressure Ulcer / Q000378:metabolism* / Q000517:prevention & control*; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data; D012307:Risk Factors
chemical_list: D010100:Oxygen