Singular Predictors of Hospital-Acquired Pressure Injuries Under Intensive Care: A Retrospective Cohort Study in a Medium-Complexity Hospital

• Published in: Clinical nursing research 2022-05, Vol.31 (4), p.639-647
• Main Authors: Argenti, Graziela, Ishikawa, Gerson, Fadel, Cristina Berger, Gomes, Ricardo Zanetti
• Format: Article
• Language: English
• Subjects: Adult; Cohort analysis; Critical Care; Hospitalization; Hospitals; Humans; Hypotension; Iatrogenesis; Intensive care; Intensive Care Units; Length of Stay; Mechanical ventilation; Medical records; Norepinephrine; Pressure Ulcer; Pressure ulcers; Retrospective Studies; Sensory perception; Ventilation; Ventilators
• ISSN: 1054-7738; 1552-3799
• DOI: 10.1177/10547738211051567

A retrospective cohort study of hospital-acquired pressure injuries (HAPI) reported an incidence rate of 34.3% based on 582 medical records of adult patients admitted to the intensive care unit (ICU) of a medium-complexity public hospital in 2017 and 2018. Sixty percent of the patients used respirators, 49.3% presented hypotension, and 48.1% used norepinephrine. The main individual predictors of HAPI in the ICU were “days of norepinephrine” with an odds ratio (OR) of 1.625 (95% CI: 1.473–1.792) and concordance statistic (AUC) of 0.818 (95% CI: 0.779–0.857), “days of mechanical ventilation” with an OR of 1.521 (1.416–1.634) and AUC of 0.879 (0.849–0.909), “ICU stay (days)” with an OR of 1.279 (1.218–1.342) and AUC of 0.846 (0.812–0.881), and “Braden’s sensory perception” with an OR of 0.345 (95% CI: 0.278–0.429) and AUC of 0.760 (0.722–0.799). The duration of mechanical ventilation, norepinephrine administration, and ICU length of stay presented significant discriminative capacity for HAPI prediction.