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Crit Care Med. 2001 Feb;29(2):283-90.
Incidence of pressure ulcers in a
neurologic intensive care unit.
Fife C, Otto G, Capsuto EG, Brandt K,
Lyssy K, Murphy K, Short C.
Department of Anesthesiology, The University of Texas Health
Science Center, Houston, TX 77030, USA.
OBJECTIVES: To determine the risk factors
for pressure ulceration in an intensive care setting, to
evaluate the Braden scale as a predictor of pressure ulcer risk
in critically ill patients, and to determine whether pressure
ulcers are likely to occur early in the hospital stay. DESIGN:
Cohort study of patients with no preexisting ulcers with a
3-month enrollment period. SETTING: The neurologic intensive
care unit and the neurologic intermediate unit at a primary
care/referral hospital with a level I trauma center. PATIENTS: A
total of 186 patients entered the study. INTERVENTION: Within 12
hrs of admittance, initial assessment, photographs, and Braden
score were completed. Patients were re-examined every 4 days or
at discharge from the unit, whichever came first. MAIN OUTCOME
MEASURES: Determining risk factors for pressure ulcers,
performing detailed statistical analyses, and testing the
usefulness of the Braden score as a predictor of pressure ulcer
risk. RESULTS: Twenty-three of 186 patients developed at least
one pressure ulcer (incidence = 12.4%) after an average stay of
6.4 days. The Braden scale, which measures six characteristics
of skin condition and patient status, proved to be a primary
predictor of ulcer development. No ulcers developed in the 69
patients whose Braden score was 16 or higher. The likelihood of
developing a pressure sore was predicted mathematically from the
Braden score. However, being underweight was a significant and
distinct factor in pressure ulcer development. CONCLUSIONS:
Pressure ulcers may develop within the first week of
hospitalization in the intensive care unit. Patients at risk
have Braden scores of < or = 16 and are more likely to be
underweight. These results suggest that aggressive preventive
care should be focused on those patients with Braden scores of
< or = 13 and/or a low body mass index at admission.
Publication Types: Validation Studies
PMID: 11246307 [PubMed - indexed for
MEDLINE]
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