Incidence and risk factors associated with the presence of pressure ulcers in critically ill patients

Objective: The incidence of pressure ulcers in the literature varies from 4.7% to 18.6%. In our study, we have aimed to identify the incidence and risk factors associated with the occurrence of pressure ulcers in critically ill patients. Scope: Medical-surgical intensive care unit. Design: Prospective observational study in the period of September 2005 to August 2006. Patients and methods: We included patients without PU on admission who were hospitalized more than 48 hours in the intensive care unit (ICU) and who had any of the following risk factors for pressure ulcers: intubated and on mechanical ventilation, with vasopressor support. Main variable interest: The main variable was the presence of grade II or higher PU. Other variables studied were age, weight, body mass index, admission diagnosis, presence of infection, APACHE II (Acute Physiologic and Chronic Health Evaluation), ventilation mechanical level of sedation, presence of diarrhea, wound drainage, vasopressor support, duration of mechanical ventilation, ICU and hospital stay. Results: The study included 150 patients, with an average age of 54 years, the APACHE II averaged 18.2 +/- 8.2, 88.67% of the patients were on mechanical ventilation, days of stay in ICU were an average of 11.94 +/- 16.45. Percentage of PU grade II or higher was 26.7%. After the univariate analysis, the risk factors found were presence of infection (OR = 2.52 with a p-value = 0.013 and a 95% CI, 1.2-5.29), days of stay in ICU (p = 0.001; OR = 4.39; 95% CI, 6.92-18.25). Presence of infection (OR = 2.89; p = 0.023; 95% CI, 1.16-7.22), days of stay in the ICU (OR = 1.13; p = 0.005; 95% CI, 1.06,1.22) and a high score APACHE II (OR = 1.06; p = 0.044; 95% CI, 1-1.12) were also significant in the multivariate analysis. Conclusions: The incidence of pressure ulcers in the study population is very high. The risk factors most often found are presence of infection, days of stay and high APACHE II score. (C) 2008 Medicina Intensiva. Published by Elsevier Espana, S.L. All rights reserved.