Perioperative factors and pressure ulcer development in postoperative ICU patients: A retrospective review
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Coyer, F
David, M
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Abstract
Objective: To identify variables during surgery that may contribute to the development of pressure ulcers (PUs) in postoperative, intensive care unit (ICU) patients within 72 hours of admission, as well as over their entire ICU admission. Furthermore, to investigate how these variables may impact on the number of PUs acquired. Method: In a three-year retrospective audit, from 1 January 2014 to 31 December 2016, data from the electronic medical records of 3484 postoperative ICU patients in a major Australian metropolitan public hospital were retrieved and analysed to investigate associations between perioperative variables and PU occurrence. Results: A total of 69 ICU admissions (1.98%) out of 3484 resulted in at least one PU developing within the ICU. No specific variables were associated with the development of a PU within 72 hours of the patient's ICU admission. Multiple regression Cox analysis showed that length of time in the operating theatre (OT) (p=0.045), surgical specialty (p< 0.001), 1-4 hypotensive episodes (p=0.017) and >5 hypotensive episodes (p<0.0005) were significantly associated with PU risk. Multivariable negative binomial regression demonstrated APACHE II score (p<0.01), OT time (p<0.01) and surgical specialty (p<0.01) were associated with PU number. Conclusion: There are many risks to skin integrity at the perioperative period, and these risks may exert their effect well into the ICU admission period. It is imperative to identify and mitigate these factors in order to reduce PU incidence, morbidity and mortality. Declaration of interest: There are no known conflicts of interest associated with this manuscript and there has been no financial support for this work that could have influenced its outcome. The authors did not receive any funding for this study.
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Journal of Wound Care
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27
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8
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© 2020 MA Healthcare. The attached file is reproduced here in accordance with the copyright policy of the publisher. Please refer to the journal's website for access to the definitive, published version.
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Subject
Clinical sciences
Nursing
intensive care
perioperative factors
pressure ulcer
retrospective review
skin integrity
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Kumta, N; Coyer, F; David, M, Perioperative factors and pressure ulcer development in postoperative ICU patients: A retrospective review, Journal of Wound Care, 2018, 27 (8), pp. 475-485