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Hospital‐acquired pressure ulcers and risk of hospital mortality in intensive care patients on mechanical ventilation
Author(s) -
Manzano Francisco,
PérezPérez Ana M.,
MartínezRuiz Susana,
GarridoColmenero Cristina,
Roldan Delphine,
JiménezQuintana María del Mar,
SánchezCantalejo Emilio,
Colmenero Manuel
Publication year - 2014
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/jep.12137
Subject(s) - medicine , mechanical ventilation , intensive care unit , confidence interval , hazard ratio , emergency medicine , mortality rate , prospective cohort study , multivariate analysis , intensive care medicine
Rationale, aims and objectives Pressure ulcers ( PUs ) are a common and serious complication in critically ill patients. The aim of this study was to evaluate the relationship between the development of a PU and hospital mortality in patients requiring mechanical ventilation ( MV ) in an intensive care unit ( ICU ). Methods A prospective cohort study was performed over two years in patients requiring MV for ≥ 24 hours in a medical‐surgical ICU . Primary outcome measure was hospital mortality and main independent variable was the development of a PU grade ≥ II . Hazard ratios ( HRs ) were calculated using a C ox model with time‐dependent covariates. Results Out of 563 patients in the study, 110 (19.5%) developed a PU . Overall hospital mortality was 48.7%. In the adjusted multivariate model, PU onset was a significant independent predictor of mortality (adjusted HR , 1.28; 95% confidence interval, 1.003–1.65; P = 0.047). The model also included the A cute P hysiology and C hronic H ealth E valuation II score, total S equential O rgan F ailure A ssessment on day 3, hepatic cirrhosis and medical admission. Conclusion Within the limitations of a single‐centre approach, PU development appears to be associated with an increase in mortality among patients requiring MV for 24 hours or longer.