Dependency-related skin lesions in the prone critical patient. Incidence study
To determine the incidence of dependence-related skin lesions(DRSL) in patients in prone position(PP) and to identify the predisposing factors. Follow-up study in two polyvalent intensive care units. Patients undergoing invasive mechanical ventilation and PP with no skin lesions on admission were in...
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| creator | Valls-Matarín, Josefa Peradejordi-Torres, Rosa M. Cotillo-Fuente, Mercedes del |
| description | To determine the incidence of dependence-related skin lesions(DRSL) in patients in prone position(PP) and to identify the predisposing factors.
Follow-up study in two polyvalent intensive care units. Patients undergoing invasive mechanical ventilation and PP with no skin lesions on admission were included. We recorded the 3 types of DRSL:(pressure ulcers(PU), moisture-associated skin damage(MASD) and friction injuries(FI)), demographic variables, diagnosis, length of stay, PP episodes, postural changes, APACHE II(Acute Physiology and Chronic Health Disease Classification System), prealbumin level on admission, body mass index(BMI), diabetes, hypertension, smoking, peripheral vascular disease(PVD), vasoactive drugs, Braden scale and mortality.
Bivariate analysis: chi-square test, t-test or Mann-Whitney U test. Multivariate analysis: logistic regression.
Forty nine patients were included and 170 PP were performed.Forty-one DRSL appeared in 22 patients with a cumulative incidence of 44.9%(95%CI: 31.6-58.7). PU accounted for 63.4% (73.1% facial; 76.9% stage II), 12.2% were MASD (60% inguinal; 60% stage II) and 24.4% were FI(50% thoracic; 70% stage III).
The median age of the lesion group (LG) was 66.5 [61.8-71.3] vs 64 [43-71] years old in the non-lesion group (NLG), p = 0.04. Eighty percent of the LG had PVD vs 20% of the NLG, p = 0.03. The median total hours on PP of the LG was 96.9 [56.1-149.4] vs 38.2 [18.8-57] of the NIG, p |
| doi_str_mv | 10.1016/j.enfcle.2023.10.005 |
| format | Article |
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Follow-up study in two polyvalent intensive care units. Patients undergoing invasive mechanical ventilation and PP with no skin lesions on admission were included. We recorded the 3 types of DRSL:(pressure ulcers(PU), moisture-associated skin damage(MASD) and friction injuries(FI)), demographic variables, diagnosis, length of stay, PP episodes, postural changes, APACHE II(Acute Physiology and Chronic Health Disease Classification System), prealbumin level on admission, body mass index(BMI), diabetes, hypertension, smoking, peripheral vascular disease(PVD), vasoactive drugs, Braden scale and mortality.
Bivariate analysis: chi-square test, t-test or Mann-Whitney U test. Multivariate analysis: logistic regression.
Forty nine patients were included and 170 PP were performed.Forty-one DRSL appeared in 22 patients with a cumulative incidence of 44.9%(95%CI: 31.6-58.7). PU accounted for 63.4% (73.1% facial; 76.9% stage II), 12.2% were MASD (60% inguinal; 60% stage II) and 24.4% were FI(50% thoracic; 70% stage III).
The median age of the lesion group (LG) was 66.5 [61.8-71.3] vs 64 [43-71] years old in the non-lesion group (NLG), p = 0.04. Eighty percent of the LG had PVD vs 20% of the NLG, p = 0.03. The median total hours on PP of the LG was 96.9 [56.1-149.4] vs 38.2 [18.8-57] of the NIG, p < 0.001. Multivariate analysis selected total PP hours(OR = 1.03;95%CI:1.01-1.05) and PVD(OR = 8.9;95%CI:1.3-58.9) as predisposing factors for developing DRSL.
There is a high incidence of skin lesions related to prone decubitus dependence, mostly pressure lesions, although of low severity.The accumulated hours in probe position and peripheral vascular disease favor their development.
Determinar la incidencia de lesiones cutáneas relacionadas con la dependencia (LCRD) en pacientes en decúbito prono (DP) e identificar los factores predisponentes.
Estudio descriptivo-longitudinal en dos unidades de cuidados intensivos (UCI) polivalentes. Se incluyeron pacientes con ventilación mecánica invasiva y DP, sin lesiones al ingreso. Se registraron 3 tipos de LCRD: (lesiones por presión(LPP), lesiones cutáneas asociadas a la humedad(LESCAH) y lesiones por fricción(LF)), variables demográficas, diagnóstico, estancia, episodios en DP, cambios posturales, APACHE II (Acute Physiology and Chronic Health Disease Classification System), prealbúmina al ingreso, índice de masa corporal (IMC), diabetes, hipertensión arterial, tabaquismo, enfermedad vascular periférica (EVP), drogas vasoactivas, escala Braden y mortalidad. Análisis bivariante: prueba de X2, t-Student o U de Mann-Whitney. Multivariante: regresión logística.
Se incluyeron 49 pacientes. Se realizaron 170 DP. Aparecieron 41 LCRD en 22 pacientes con una incidencia acumulada de 44,9% (IC95%:31,6-58,7). El 63,4% LPP(73,1% faciales;76,9% categoría II), el 12,2% LESCAH (60% inguinales;60% categoría II) y el 24,4% LF(50% torácicas; 70% categoría III). La mediana de edad del grupo con lesiones (GCL) fue de 66,5 [61,8–71,3] frente al 64[43-71] años del grupo sin lesiones(GSL), p = 0,04. El 80% del GCL tenía EVP frente al 20% del GSL, p = 0,03. La mediana de horas totales en DP del GCL fue 96,9 [56,1–149,4] frente a 38,2[18,8-57] del GSL, p < 0,001. El análisis multivariante seleccionó horas totales DP(OR = 1,03;IC95%:1,01-1,05) y la EVP(OR = 8,9;IC95%:1,3-58,9) como factores predisponentes para desarrollar LCRD.
Existe una elevada incidencia de lesiones cutáneas relacionadas con la dependencia en decúbito prono, mayoritariamente lesiones por presión, aunque de baja severidad. Las horas acumuladas en decúbito prono y la enfermedad vascular periférica favorecen su desarrollo.</description><identifier>ISSN: 2445-1479</identifier><identifier>EISSN: 2445-1479</identifier><identifier>DOI: 10.1016/j.enfcle.2023.10.005</identifier><language>eng</language><publisher>Elsevier España, S.L.U</publisher><subject>critical care ; cuidados críticos ; decúbito prono ; friction injury ; incidence ; incidencia ; intertrigo ; Key words ; lesión por fricción ; lesión por humedad ; moisture lesion ; pressure ulcer ; prone position ; úlcera por presión</subject><ispartof>Enfermería clínica (Internet. English ed.), 2023-11, Vol.33 (6), p.424-431</ispartof><rights>2023</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c1333-2d0905c3b1f1d15de8a245b74d38f263c78df5edf73d46b3e48a7ecc4a0344ce3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids></links><search><creatorcontrib>Valls-Matarín, Josefa</creatorcontrib><creatorcontrib>Peradejordi-Torres, Rosa M.</creatorcontrib><creatorcontrib>Cotillo-Fuente, Mercedes del</creatorcontrib><title>Dependency-related skin lesions in the prone critical patient. Incidence study</title><title>Enfermería clínica (Internet. English ed.)</title><description>To determine the incidence of dependence-related skin lesions(DRSL) in patients in prone position(PP) and to identify the predisposing factors.
Follow-up study in two polyvalent intensive care units. Patients undergoing invasive mechanical ventilation and PP with no skin lesions on admission were included. We recorded the 3 types of DRSL:(pressure ulcers(PU), moisture-associated skin damage(MASD) and friction injuries(FI)), demographic variables, diagnosis, length of stay, PP episodes, postural changes, APACHE II(Acute Physiology and Chronic Health Disease Classification System), prealbumin level on admission, body mass index(BMI), diabetes, hypertension, smoking, peripheral vascular disease(PVD), vasoactive drugs, Braden scale and mortality.
Bivariate analysis: chi-square test, t-test or Mann-Whitney U test. Multivariate analysis: logistic regression.
Forty nine patients were included and 170 PP were performed.Forty-one DRSL appeared in 22 patients with a cumulative incidence of 44.9%(95%CI: 31.6-58.7). PU accounted for 63.4% (73.1% facial; 76.9% stage II), 12.2% were MASD (60% inguinal; 60% stage II) and 24.4% were FI(50% thoracic; 70% stage III).
The median age of the lesion group (LG) was 66.5 [61.8-71.3] vs 64 [43-71] years old in the non-lesion group (NLG), p = 0.04. Eighty percent of the LG had PVD vs 20% of the NLG, p = 0.03. The median total hours on PP of the LG was 96.9 [56.1-149.4] vs 38.2 [18.8-57] of the NIG, p < 0.001. Multivariate analysis selected total PP hours(OR = 1.03;95%CI:1.01-1.05) and PVD(OR = 8.9;95%CI:1.3-58.9) as predisposing factors for developing DRSL.
There is a high incidence of skin lesions related to prone decubitus dependence, mostly pressure lesions, although of low severity.The accumulated hours in probe position and peripheral vascular disease favor their development.
Determinar la incidencia de lesiones cutáneas relacionadas con la dependencia (LCRD) en pacientes en decúbito prono (DP) e identificar los factores predisponentes.
Estudio descriptivo-longitudinal en dos unidades de cuidados intensivos (UCI) polivalentes. Se incluyeron pacientes con ventilación mecánica invasiva y DP, sin lesiones al ingreso. Se registraron 3 tipos de LCRD: (lesiones por presión(LPP), lesiones cutáneas asociadas a la humedad(LESCAH) y lesiones por fricción(LF)), variables demográficas, diagnóstico, estancia, episodios en DP, cambios posturales, APACHE II (Acute Physiology and Chronic Health Disease Classification System), prealbúmina al ingreso, índice de masa corporal (IMC), diabetes, hipertensión arterial, tabaquismo, enfermedad vascular periférica (EVP), drogas vasoactivas, escala Braden y mortalidad. Análisis bivariante: prueba de X2, t-Student o U de Mann-Whitney. Multivariante: regresión logística.
Se incluyeron 49 pacientes. Se realizaron 170 DP. Aparecieron 41 LCRD en 22 pacientes con una incidencia acumulada de 44,9% (IC95%:31,6-58,7). El 63,4% LPP(73,1% faciales;76,9% categoría II), el 12,2% LESCAH (60% inguinales;60% categoría II) y el 24,4% LF(50% torácicas; 70% categoría III). La mediana de edad del grupo con lesiones (GCL) fue de 66,5 [61,8–71,3] frente al 64[43-71] años del grupo sin lesiones(GSL), p = 0,04. El 80% del GCL tenía EVP frente al 20% del GSL, p = 0,03. La mediana de horas totales en DP del GCL fue 96,9 [56,1–149,4] frente a 38,2[18,8-57] del GSL, p < 0,001. El análisis multivariante seleccionó horas totales DP(OR = 1,03;IC95%:1,01-1,05) y la EVP(OR = 8,9;IC95%:1,3-58,9) como factores predisponentes para desarrollar LCRD.
Existe una elevada incidencia de lesiones cutáneas relacionadas con la dependencia en decúbito prono, mayoritariamente lesiones por presión, aunque de baja severidad. Las horas acumuladas en decúbito prono y la enfermedad vascular periférica favorecen su desarrollo.</description><subject>critical care</subject><subject>cuidados críticos</subject><subject>decúbito prono</subject><subject>friction injury</subject><subject>incidence</subject><subject>incidencia</subject><subject>intertrigo</subject><subject>Key words</subject><subject>lesión por fricción</subject><subject>lesión por humedad</subject><subject>moisture lesion</subject><subject>pressure ulcer</subject><subject>prone position</subject><subject>úlcera por presión</subject><issn>2445-1479</issn><issn>2445-1479</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp9UD1PwzAUtBBIVNB_wOCRJcGfSbogofJVqYIFZst9fhEuqVNsF6n_nkRhYGJ6p9Pd6d0RcsVZyRmvbrYlhhY6LAUTcqBKxvQJmQmldMFVvTj9g8_JPKUtY0zoRVXVbEZe7nGPwWGAYxGxsxkdTZ8-0A6T70OiA8wfSPexD0gh-uzBdnRvs8eQS7oK4Ec30pQP7nhJzlrbJZz_3gvy_vjwtnwu1q9Pq-XdugAupSyEYwumQW54yx3XDhsrlN7UysmmFZWEunGtRtfW0qlqI1E1tkYAZZlUClBekOspd_jr64Apm51PgF1nA_aHZETTSN1IoeQgVZMUYp9SxNbso9_ZeDScmXFBszXTgmZccGSHBQfb7WTDoca3x2gS-LGo8xEhG9f7_wN-AK-Ke6I</recordid><startdate>202311</startdate><enddate>202311</enddate><creator>Valls-Matarín, Josefa</creator><creator>Peradejordi-Torres, Rosa M.</creator><creator>Cotillo-Fuente, Mercedes del</creator><general>Elsevier España, S.L.U</general><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202311</creationdate><title>Dependency-related skin lesions in the prone critical patient. Incidence study</title><author>Valls-Matarín, Josefa ; Peradejordi-Torres, Rosa M. ; Cotillo-Fuente, Mercedes del</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1333-2d0905c3b1f1d15de8a245b74d38f263c78df5edf73d46b3e48a7ecc4a0344ce3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>critical care</topic><topic>cuidados críticos</topic><topic>decúbito prono</topic><topic>friction injury</topic><topic>incidence</topic><topic>incidencia</topic><topic>intertrigo</topic><topic>Key words</topic><topic>lesión por fricción</topic><topic>lesión por humedad</topic><topic>moisture lesion</topic><topic>pressure ulcer</topic><topic>prone position</topic><topic>úlcera por presión</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Valls-Matarín, Josefa</creatorcontrib><creatorcontrib>Peradejordi-Torres, Rosa M.</creatorcontrib><creatorcontrib>Cotillo-Fuente, Mercedes del</creatorcontrib><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Enfermería clínica (Internet. English ed.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Valls-Matarín, Josefa</au><au>Peradejordi-Torres, Rosa M.</au><au>Cotillo-Fuente, Mercedes del</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Dependency-related skin lesions in the prone critical patient. Incidence study</atitle><jtitle>Enfermería clínica (Internet. English ed.)</jtitle><date>2023-11</date><risdate>2023</risdate><volume>33</volume><issue>6</issue><spage>424</spage><epage>431</epage><pages>424-431</pages><issn>2445-1479</issn><eissn>2445-1479</eissn><abstract>To determine the incidence of dependence-related skin lesions(DRSL) in patients in prone position(PP) and to identify the predisposing factors.
Follow-up study in two polyvalent intensive care units. Patients undergoing invasive mechanical ventilation and PP with no skin lesions on admission were included. We recorded the 3 types of DRSL:(pressure ulcers(PU), moisture-associated skin damage(MASD) and friction injuries(FI)), demographic variables, diagnosis, length of stay, PP episodes, postural changes, APACHE II(Acute Physiology and Chronic Health Disease Classification System), prealbumin level on admission, body mass index(BMI), diabetes, hypertension, smoking, peripheral vascular disease(PVD), vasoactive drugs, Braden scale and mortality.
Bivariate analysis: chi-square test, t-test or Mann-Whitney U test. Multivariate analysis: logistic regression.
Forty nine patients were included and 170 PP were performed.Forty-one DRSL appeared in 22 patients with a cumulative incidence of 44.9%(95%CI: 31.6-58.7). PU accounted for 63.4% (73.1% facial; 76.9% stage II), 12.2% were MASD (60% inguinal; 60% stage II) and 24.4% were FI(50% thoracic; 70% stage III).
The median age of the lesion group (LG) was 66.5 [61.8-71.3] vs 64 [43-71] years old in the non-lesion group (NLG), p = 0.04. Eighty percent of the LG had PVD vs 20% of the NLG, p = 0.03. The median total hours on PP of the LG was 96.9 [56.1-149.4] vs 38.2 [18.8-57] of the NIG, p < 0.001. Multivariate analysis selected total PP hours(OR = 1.03;95%CI:1.01-1.05) and PVD(OR = 8.9;95%CI:1.3-58.9) as predisposing factors for developing DRSL.
There is a high incidence of skin lesions related to prone decubitus dependence, mostly pressure lesions, although of low severity.The accumulated hours in probe position and peripheral vascular disease favor their development.
Determinar la incidencia de lesiones cutáneas relacionadas con la dependencia (LCRD) en pacientes en decúbito prono (DP) e identificar los factores predisponentes.
Estudio descriptivo-longitudinal en dos unidades de cuidados intensivos (UCI) polivalentes. Se incluyeron pacientes con ventilación mecánica invasiva y DP, sin lesiones al ingreso. Se registraron 3 tipos de LCRD: (lesiones por presión(LPP), lesiones cutáneas asociadas a la humedad(LESCAH) y lesiones por fricción(LF)), variables demográficas, diagnóstico, estancia, episodios en DP, cambios posturales, APACHE II (Acute Physiology and Chronic Health Disease Classification System), prealbúmina al ingreso, índice de masa corporal (IMC), diabetes, hipertensión arterial, tabaquismo, enfermedad vascular periférica (EVP), drogas vasoactivas, escala Braden y mortalidad. Análisis bivariante: prueba de X2, t-Student o U de Mann-Whitney. Multivariante: regresión logística.
Se incluyeron 49 pacientes. Se realizaron 170 DP. Aparecieron 41 LCRD en 22 pacientes con una incidencia acumulada de 44,9% (IC95%:31,6-58,7). El 63,4% LPP(73,1% faciales;76,9% categoría II), el 12,2% LESCAH (60% inguinales;60% categoría II) y el 24,4% LF(50% torácicas; 70% categoría III). La mediana de edad del grupo con lesiones (GCL) fue de 66,5 [61,8–71,3] frente al 64[43-71] años del grupo sin lesiones(GSL), p = 0,04. El 80% del GCL tenía EVP frente al 20% del GSL, p = 0,03. La mediana de horas totales en DP del GCL fue 96,9 [56,1–149,4] frente a 38,2[18,8-57] del GSL, p < 0,001. El análisis multivariante seleccionó horas totales DP(OR = 1,03;IC95%:1,01-1,05) y la EVP(OR = 8,9;IC95%:1,3-58,9) como factores predisponentes para desarrollar LCRD.
Existe una elevada incidencia de lesiones cutáneas relacionadas con la dependencia en decúbito prono, mayoritariamente lesiones por presión, aunque de baja severidad. Las horas acumuladas en decúbito prono y la enfermedad vascular periférica favorecen su desarrollo.</abstract><pub>Elsevier España, S.L.U</pub><doi>10.1016/j.enfcle.2023.10.005</doi><tpages>8</tpages></addata></record> |
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| subjects | critical care cuidados críticos decúbito prono friction injury incidence incidencia intertrigo Key words lesión por fricción lesión por humedad moisture lesion pressure ulcer prone position úlcera por presión |
| title | Dependency-related skin lesions in the prone critical patient. Incidence study |
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