Oral pressure injuries in patients hospitalized during the COVID-19 pandemic and associated factors: a cross-sectional study

Abstract

Background: Patients critically ill with coronavirus disease (COVID) who are admitted to intensive care unit (ICU) are susceptible to a vast number of complications that life-threatening. Objective: To investigate the frequency of oral cavity pressure injuries (OPI) in adult patients hospitalized for COVID in an ICU and associated factors. Method: A retrospective cross-sectional study was carried out using electronic medical records of patients admitted to the ICU, whether due to COVID or other conditions (NO COVID), in São Luís, Maranhão, Brazil. Demographic data, comorbidities, length of stay, intubation time, O2 saturation, use of vasoactive drugs, and hospitalization (due to COVID or NO COVID), and OPI were extracted from the medical records. The data was subjected to descriptive statistics, Chi-square test, Mann-Whitney test and Poisson regression (α=5%). Results: The frequency of OPI in patients hospitalized for COVID was 38.5%. The most frequent comorbidities in both groups were hypertension and diabetes mellitus. The use of vasoactive drugs and OPI was more frequent in the NO COVID group (p=0.010; p=0.021). The average length of stay was significantly longer for the COVID group (15.8 days) compared to the NO COVID group (10.6 days) (p=0.025). The average length of hospitalization and intubation was significantly higher for the group with OPI (p=0.003; p<0.001). In the adjusted regression analysis, the length of intubation was the factor suggestive of explaining to OPI (PR=2.547; CI=1.423-4.558). Conclusion: Longer hospitalization and intubation times were responsible for pressure injuries in the oral cavity, demonstrating the need for continuous assessment of hospitalized patients in order to prevent the establishment of these injuries.