Risk Factors for Intraoperative Pressure Injury in Aortic Surgery: A Nested Case-Control Study

Abstract

Aims and Objectives: The aim of this study was to identify risk factors associated with an increased risk of intraoperative pressure injury in patients undergoing aortic surgery. Background: Intraoperative pressure injuries are some of the most significant health problems in clinical practice. According to previous studies, patients undergoing aortic surgery are at high risk of developing an intraoperative pressure injury, with an incidence much higher than that associated with other types of cardiac surgery. Design: This was a nested case-control study. Methods: Following the STROBE checklist, a nested case-control approach was adopted in this study. A patient cohort was selected on the basis of inclusion and exclusion criteria from patients undergoing aortic surgery. Data were collected from these patients by means of a tailored questionnaire designed in-house. Patients with intraoperative pressure injury at the end of surgery were identified as the case group, while the control group consisted of patients without intraoperative pressure injury. Patients in the groups underwent 1:1 matching based on age and sex. Initially, a single-factor analysis was conducted between the two groups. Subsequently, risk factors for intraoperative pressure injury were identified through conditional logistic regression analysis with use of the variables that exhibited statistically significant differences in the single-factor analysis. Results: A total of 400 patients were selected. Among these, 167 patients experienced intraoperative pressure injury at an incidence rate of 41.8%. Strict preoperative bed confinement, deep hypothermic circulatory arrest during surgery, application of norepinephrine or dopamine during surgery, and intraoperative skin wetting were associated with the occurrence of intraoperative pressure injury in patients undergoing aortic surgery. Conclusions: Nurses should thoroughly assess the risk of intraoperative pressure injury and implement appropriate preventative interventions, particularly in high-risk patients undergoing aortic surgery.