Determination of the risk factors that will play a role in the pressure sore prevalence and the development of pressure sore in patients hospitalized in a chest cardiovascular surgical intensive care unit

Tülin Akarsu Ayazoğlu
2018 Eurasian Journal of Medical Investigation  
D efined as pressure ulcer, bedsore, decubitus ulcers, or decubitus, the "pressure sore" is one of the important health problems in our country. Pressure sores are an important burden both on patients and their relatives and/or caregivers. These injuries not only cause pain and discomfort but also have a major negative impact on quality of life. In addition, pressure sore is a health problem that increases the risk of mortality and morbidity, prolongs the length of stay in the hospital,
more » ... e hospital, increases the treatment costs, and reflects the quality of patient care services. [1] [2] [3] [4] [5] [6] The European Pressure Ulcer Advisory Panel (EPUAP) defines the pressure sore as the localized tissue damage that occurs with pressure, friction, irritation or ulcer as a result of extreme and prolonged pressure on the skin or in subcutaneous tissues. [7] The most important feature of pressure sores is that they can be prevented if appropriate precautions are taken. Objectives: The incidence of pressure sores, which can cause morbidity and mortality in chest and cardiac surgery patients, was reported to be up to 41% in intensive care patients. However, pressure sores can be avoided if the appropriate precautions are taken. In this study, the objective was to determine risk factors that play a role in the development and prevalence of pressure sores in cardiac surgery patients. Methods: The study included 1956 patients who underwent cardiothoracic surgery and who stayed in the intensive care unit (ICU) for more than 48 hours. The data were obtained retrospectively from nurse and physician follow-up records. The patients were evaluated in terms of demographic and clinical characteristics, and factors such as the presence of a pressure ulcer on admission to the ICU, the grade of the pressure sore, and a Braden pressure sore risk score. The risk factors were compared in patients who did and did not develop pressure sores during their ICU stay. Results: In this study, the prevalence of pressure sores was 2.1%. Advanced age (62.17±41 years), a high Euroscope value, the presence of diabetes mellitus, peripheral vascular disease, preoperative atrial fibrillation, ejection fraction <30%, and urgency of operation were among the preoperative risk factors for the development of decubitus ulcers, and significant postoperative risk factors were a level of low hemoglobin or glucose, hypoalbuminemia, and a lengthy period of mechanical ventilation or intensive care. Conclusion: Patients in cardiovascular and thoracic surgery ICUs should be evaluated for pressure sores in the early period. Prompt identification and control of risk factors reduces hospitalization time, morbidity, and most importantly, mortality.
doi:10.14744/ejmi.2018.43153 fatcat:zo2ymauqtnbmxac5ii2t4chtse