title: Pressure Ulcers: Developing Clinical Indicators in Evidence-based Practice. A Prospective Study.
abstract: OBJECTIVE
  It is widely recognized that Intensive Care Unit (ICU) patients have a greater likelihood of developing pressure ulcers in comparison to hospital or home care patients. Accordingly, this study aimed to evaluate whether specific clinical characteristics could be used as clinical indicators towards pressure ulcers prevention.
  
  
  METHODS
  We monitored 210 hospitalized ICU patients during a 12-month period. Pressure ulcers were assessed following the current guidelines. Clinical characteristics such as gender, age, hospitalized days, hemodialysis treatment, hematocrit, and serum albumin levels were considered as the most common predictors for pressure ulcers development. The significance of associations was controlled using multiple logistic regression after adjusting for clinical characteristics and was presented as adjusted odds ratio (AOR).
  
  
  RESULTS
  The prevalence of pressure ulcers was 24.3%. Logistic regression revealed that patients with increased age AOR=1.04; (CI: 1.01-1.07) and last-long hospitalization AOR=1.17; (CI: 1.11-1.23) were significantly more likely to present pressure ulcers compared to the younger ones and patients with less length of stay, respectively. We also found that patients under hemodialysis treatment were more likely to present pressure ulcers AOR=4.09; (CI: 1.12-14.98) compared to patients that did not underwent hemodialysis and the risk of pressure ulcers development was decreased by 9% for every single unit of hematocrit value increase AOR=0.91; (CI: 0.82-0.99).
  
  
  CONCLUSIONS
  Our data analysis confirms that the clinical characteristics that were studied are independently associated with pressure ulcers development, and therefore, it is a crucial incentive to consider that these specific clinical characteristics are important indicators in the evidence-based practice.
authors.affiliation: Nursing Department, Technological Educational Institute of Thessaly, Larissa, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Tsaras
authors.affiliation: University Hospital of Larissa, Larissa, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Chatzi
authors.affiliation: Nursing Department, Technological Educational Institute of Crete, Heraklion, Greece.
authors.forename: Christos F
authors.initials: CF
authors.lastname: Kleisiaris
authors.affiliation: State Mental Hospital of Attica "Daphne", Athens, Greece.
authors.forename: Evangelos C
authors.initials: EC
authors.lastname: Fradelos
authors.affiliation: Nursing Department, "Alexander" Technological Educational Institute of Thessaloniki, Thessaloniki, Greece.
authors.forename: Lambrini
authors.initials: L
authors.lastname: Kourkouta
authors.affiliation: Nursing Department, Technological Educational Institute of Thessaly, Larissa, Greece.
authors.forename: Ioanna V
authors.initials: IV
authors.lastname: Papathanasiou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care; D005260:Female; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D003668:Pressure Ulcer / Q000453:epidemiology* / Q000517:prevention & control*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: evidence-based practice; intensive care unit; predictors; pressure ulcers; prevention; risk factors