Occurrence Of Pressure Injuries Research Articles

Investigation on the Alleviating Effect of Standardized Three-Step Nursing on Perioperative Pressure Injury in Patients with Spinal Fracture Accompanied by Spinal Cord Injury

Objective: To explore the alleviating effect of standardized three-step nursing on perioperative pressure injury in patients with spinal fracture accompanied by spinal cord injury. Methods: A retrospective analysis was conducted on the clinical data of 153 patients who underwent surgical treatment for spinal fracture accompanied by spinal cord injury in our hospital from January 2021 to January 2024. All patients met the criteria for inclusion and exclusion. According to the nursing interventions received during the perioperative period, the patients were divided into a control group (n = 76) and an observation group (n = 77). The control group received routine nursing interventions during the perioperative period, while the observation group received standardized three-step nursing interventions. The occurrence, severity, area, and pain [Visual Analog Scale (VAS)], coagulation indicators [Prothrombin Time (PT), Fibrinogen (FIB), D-dimer (D-D)], activities of daily living [Barthel Index], and quality of life [General Quality of Life Inventory (GQOLI-74)] were compared between the two groups. Results: ① Occurrence and severity of perioperative pressure injury: In the control group, 18 cases of pressure injury occurred, including 5 cases of stage I, 11 cases of stage II, and 2 cases of stage III; In the observation group, 7 cases of pressure injury occurred, including 4 cases of stage I and 3 cases of stage II. The occurrence rate and severity of pressure injury in the observation group were lower than those in the control group (P < 0.05). ② Area of injury and pain: The area of injury on the day of surgery and 5 days after surgery in the observation group was lower than that in the control group (P < 0.05); The VAS score 5 days after surgery in the observation group was lower than that in the control group (P < 0.05). ③ Coagulation indicators: 5 days after surgery, the levels of D-D and FIB in the observation group were lower than those in the control group, while PT was higher than that in the control group (P < 0.05). ④ Activities of daily living and quality of life: 3 months after surgery, the Barthel score and GQOLI-74 score in the observation group were higher than those in the control group (P < 0.05). Conclusion: Standardized three-step nursing can significantly reduce the occurrence rate, severity, and area of perioperative pressure injury in patients with spinal fracture accompanied by spinal cord injury, alleviate patient pain, improve coagulation function, and enhance levels of activities of daily living and quality of life.

Influences of evidence-based nursing intervention on pressure ulcers in intensive care units: A meta-analysis.

A meta-analysis was conducted comprehensively to investigate the impact of evidence-based nursing (EBN) interventions on pressure injury (PI) in the intensive care unit (ICU) patients. Computer searches were performed, from databases inception to November 2023, in Wanfang, PubMed, China National Knowledge Infrastructure, Google Scholar, Embase, and Cochrane Library for randomized controlled trials (RCTs) on the application of EBN interventions in ICU patients. Two independent researchers conducted screenings of the literature, extracted data, and carried out quality evaluations. Stata 17.0 software was employed for data analysis. Overall, 25 RCTs, involving 2494 ICU patients, were included. It was found that compared to conventional care methods, the implementation of EBN interventions in ICU patients markedly decreased the occurrence of PI (odds ratio [OR]: 0.22, 95% confidence interval [CI]: 0.17-0.30, p < 0.001), delayed the onset time of pressure ulcers (standardized mean difference [SMD]: -1.61, 95% CI: -2.00 to -1.22, p < 0.001), and also improved nursing satisfaction (OR: 1.18, 95% CI: 1.14-1.23, p < 0.001). Our findings suggest the implementation of EBN interventions in the care of PI in ICU patients is highly valuable, can reduce the occurrence of PI, can delay the time of appearance, and is associated with relatively higher nursing satisfaction, making it worthy of promotion.

Explore the effect of pressure and time of compression on the risk of intraoperatively acquired pressure injury based on theoretical framework: A prospective study.

Surgery is a high risk factor for the occurrence of pressure injury (PI). On the basis of theoretical research, pressure and duration of pressure are key factors affecting PI. Pressure is affected by the individual pressure redistribution capacity. So our study aims to explore how the surgery time and pressure intensity affect the occurrence of PI and what are the risk factors. A prospective study. A total of 250 patients who underwent elective surgery in a grade-A general hospital from November 2021 to February 2023 were selected and divided into a group of 77 patients with IAPI (intraoperatively acquired pressure injury) and a group of 173 patients with no IAPI. Visual pressure inductive feedback system and body composition analysis technology were used to record the local pressure value and change of patients before and after anaesthesia. Relevant data of the patients were collected to explore the influencing factors. The maximum pressure and average pressure at the pressure site of the same patient changed before and after anaesthesia, and the pressure after anaesthesia was significantly higher than that before anaesthesia. There was no statistical difference in the average pressure after anaesthesia (p > 0.05), but the maximum pressure in the IAPI group was higher than that in the non-occurrence group (p < 0.05). The average pressure multiplied by the operation time in IAPI group is significantly higher than that in the non-IAPI group (p < 0.01). Multiple linear regression analysis (stepwise regression) showed that fat-free weight, age, waist circumference, body mass index (BMI) and gender were taken as independent variables into the regression model, affecting the maximum pressure. In addition, operation time ≥4 h may be a high risk factor for IAPI. In future studies, more objective research tools can be applied to improve the accuracy of predicting the risk of IAPI. In addition to gender and BMI, follow-up studies may consider including measures such as waist circumference and fat-free body weight in IAPI risk assessment to guide the clinical nursing work more scientifically.

A machine learning algorithm-based predictive model for pressure injury risk in emergency patients: A prospective cohort study

ObjectivesTo construct pressure injury risk prediction models for emergency patients based on different machine learning algorithms, to optimize the best model, and to provide a suitable assessment tool for preventing the occurrence of pressure injuries in emergency patients. MethodsA convenience sampling was used to select 312 patients admitted to the emergency department of a tertiary care hospital in Tianjin, China, from May 2022 to March 2023, and the patients were divided into a modeling group (n = 218) and a validation group (n = 94) in a 7:3 ratio. Based on the results of one-factor logistic regression analysis in the modeling group, three machine learning models, namely, logistic regression, decision tree, and neural network, were used to establish a prediction model for pressure injury in emergency patients and compare their prediction effects. The optimal model was selected for external validation of the model. ResultsThe incidence of pressure injuries in emergency patients was 8.97 %, 64.52 % of pressure injuries occurred in the sacrococcygeal region, and 64.52 % were staged as stage 1. Serum albumin level, incontinence, perception, and mobility were independent risk factors for pressure injuries in emergency patients (P < 0.05), and the area under the ROC curve of the three models was 0.944–0.959, sensitivity was 91.8–95.5 %, specificity was 72.2–90.9 %, and the Yoden index was 0.677–0.802; the decision tree was the best model that The area under the ROC curve for the validation group was 0.866 (95 % CI: 0.688–1.000), with a sensitivity of 89.8 %, a specificity of 83.3 %, and a Yoden index of 0.731. ConclusionsThe decision tree model has the best predictive efficacy and is suitable for individualized risk prediction of pressure injuries in emergency medicine specialties, which provides a reference for the prevention and early intervention of pressure injuries in emergency patients.

Effectiveness of Pressure Relief Pads in Preventing Bi-Level Positive Airway Pressure- Related Injuries: A Secondary Database Analysis

&lt;p&gt;目的：透過雙相型陽壓呼吸器(BiPAP)通報資料庫分析，探討減壓墊於BiPAP相關壓傷之預防成效。方法：方便取樣南部某區域教學醫院成人內科加護病房之BiPAP通報資料庫，次級資料分析減壓墊於BiPAP相關壓傷之預防成效。結果：減壓墊組的壓傷發生率為6.06%，無減壓墊組為7.78%，兩組無統計顯著差異(p =.5863)。壓傷個案相關變項比較，減壓墊組比無減壓墊組平均延緩21.18小時產生壓傷(p =.8660)，平均減少0.12個壓傷(p =.5501)、減少1.96 cm2的壓傷表面積(p =.7334)，較低的重度壓傷發生風險(risk ratio = 0.44, p =.1666)，然礙於臨床發生壓傷的個案數偏少，故成效比較尚未達顯著差異。結論：兩組比較雖未達顯著差異，但次級資料庫的真實世界數據顯示減壓墊組具有較佳的預防壓傷臨床效益，建議臨床仍可善用減壓墊於預防BiPAP相關壓傷。&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;&lt;p&gt;&amp;quot;Purpose: To compare the effectiveness of pressure relief pads in preventing bi-level positive airway pressure-related injuries by analyzing data from a medical reporting database. Methods: The authors took a convenience sample of records from the medical reporting database of the adult medical intensive care unit of a regional teaching hospital in southern Taiwan. Secondary database analysis was employed to examine the effectiveness of pressure relief pads in preventing pressure injuries. Results: The incidence of pressure-related injuries in the pressure relief pads group was 6.06%, whereas the incidence in the no relief pads group was 7.78% (p = .5863). Pressure relief pads delayed the occurrence of pressure injuries by 21.18 hours (p = .8660), reduced the number of pressure injury lesions by 0.12 (p = .5501), reduced the surface area of pressure injuries by 1.96 cm2 (p = .7334), and reduced the risk of severe pressure injury (risk ratio = 0.44, p = .1666). Due to the small number of clinical incident pressure injuries reported, the comparison of effectiveness did not reach statistical significance. Conclusion: Although no significant difference was observed between the two groups, real-world data from the secondary database revealed that the pressure relief pads effectively and safely prevented pressure injuries.&lt;/p&gt; &lt;p&gt;&amp;nbsp;&lt;/p&gt;

Pressure injury risk factors in adult orthopaedic surgical patients: a cross-sectional study and random forest.

To identify the most important risk factors for predicting pressure injury (PI) occurrence in adult orthopaedic surgical patients based on investigation data, thereby identifying at-risk patients and facilitating formulation of an effective patient care strategy. Patients were assessed with an instrument designed by the authors specifically for this study in a cross-sectional investigation following the STROBE checklist. The random forest method was adopted to select the most important risk factors and predict occurrence of PIs. A dataset of 27 risk factors from 1701 patients was obtained. A subset of the 15 most important risk factors was identified. The random forest method had a high prediction accuracy of 0.9733 compared with 0.9281 calculated with a logistic model. Results indicated that the selected 15 risk factors, such as activity ability, friction/shear force, skin type and anaesthesia score, performed very well in predicting the occurrence of PIs in adult orthopaedic surgical patients.

Intrinsic and Extrinsic Risk Factors for Nosocomial Pressure Injury among Hospitalized Adults at a Tertiary Hospital in Western Kenya

The high incidence and prevalence of nosocomial pressure injuries pose a threat to safe hospitalization and additional strain on the healthcare system. Analysis of pressure injury risk factors is necessary for efficient prevention and management as part of the program to ensure that no patient experiences any preventable harm while receiving care, as per the international patient safety goals. This study evaluated the intrinsic and extrinsic risk factors for pressure injury among cohorts of hospitalized adults using a prospective approach. The Braden Scale was used to assess the participants’ level of risk and classify low (score 15 to 23) and high (score 6 to 14) cohorts prior to follow-up. Binary regression analysis was used to establish an association between the risk factors and the development of stage 2 and above pressure injuries and the odds reported. The intrinsic factors—nutrition, sex, age, and primary diagnosis—influenced the occurrence of pressure injuries. Similarly, the extrinsic factors—sensory perception, moisture, mobility and activity, presence of a medical device, friction, and shear—showed an association with the development of pressure injuries. Poor nutrition, impaired mobility, and persistent moisture, however, were statistically the most significantly associated risk factors, at OR 18.20, CI 2.18–151.69, p =.01; OR 20.93, CI 1.13–387.92, p =.04; OR 16.11, CI 2.02–128.52, p =.01, respectively, confirming a significant association between intrinsic and extrinsic risk factors and the development of hospital-acquired pressure injury. These identified risk factors can be used to tailor intervention earlier on admission and avert these preventable injuries. Standardized, timely risk assessment and proactive addressing of the identified risk factor among hospitalized patients are therefore recommended.

Retrospective investigation of pressure injury in COVID-19 patients followed on invasive mechanical ventilator support

AimIn this study, we aimed to investigate pressure injury (PI) and its associated factors in COVID-19 patients receiving invasive mechanical ventilation (IMV). MethodsThis was designed as a retrospective, descriptive and correlational study. In this study, there was no sample selection, and the data were collected by reviewing the files of 438 patients who had been followed up on IMV in the intensive care unit (ICU) with a diagnosis of COVID-19 between April 30, 2020, and April 30, 2022. The collected data were analyzed using descriptive statistics in the Statistical Package for the Social Sciences (SPSS) program. ResultsA total of 305 pressure injuries occurred in 36.3% of 438 patients receiving IMV. It was found that the length of IMV stay of the patients accelerated the occurrence of PI and that the length of stay in the intensive care unit, albumin and hemoglobin levels, Braden Pressure Sore Risk Assessment Score, APACHE-II value, nutritional status, glutamine supplementation, and vasopressor use were found to be significantly correlated with the incidence of PI (p < 0.05). ConclusionsPatients with COVID-19 who were followed up on IMV had a high incidence of PI, and prolonged ICU stays and intubations duration as well as low albumin and hemoglobin levels increased the occurrence of PI. Hence, it is recommended that the PI risk levels of COVID-19 patients followed up on IMV should be evaluated frequently and nursing interventions should be implemented according to the evaluations.

Effect of Implementing Pressure Ulcer Prevention Bundle on Occurrence of Hospital-Acquired Pressure Injuries.

Effect of Implementing Pressure Ulcer Prevention Bundle on Occurrence of Hospital-Acquired Pressure Injuries.

Prevention of pressure injuries using a non-motorised decompression air mattress: a non-interventional study.

Prevention of pressure injuries (PI) is a public health issue. Among the preventive measures, the use of support surfaces adapted to the risk of PI occurrence is recommended. This study aimed to report the incidence of PIs in patients at medium-to-high risk of occurrence of PIs and using a new non-motorised automated decompression air mattress combined with other recommended PI prevention measures. An observational, national, multicentre, prospective, non-comparative study, with a follow-up period of 35 days was conducted. Patients at medium-to-high risk of PIs and without PIs at baseline were included if they were lying on a specific non-powered automated decompression air mattress. The primary outcome was the percentage of patients who developed at least one category 2 or more severe PI of the sacrum, backbone or heel between day 0 and day 35. In total, 81 patients were included from four participating centres. There was one report of a patient with a PI that fitted within the definition of the primary outcome, meaning an incidence of 1.2% (95% confidence interval (CI) 0-6.7%). More than 80% of patients rated the overall comfort and the stability of the non-motorised automated decompression air mattress as satisfactory or very satisfactory. In more than 80% of cases, the healthcare teams found the use of the mattress to be easy or very easy. This study has shown that in combination with other preventive measures, the use of a specific non-motorised air mattress with automated decompression is associated with a low incidence of PIs in patients with medium-to-high risk of occurrence of PIs.

Epidemiological characteristics of pressure injury and the predictive validity of Braden scale among the older hospitalized patients: A cross-sectional study.

To investigate the epidemiological characteristics of pressure injury (PI) in older inpatients and predictive validity of the Braden scale. Cross-sectional study. Conducted in a 2600-bed tertiary hospital in Northwestern China from January to June 2022, the study included older patients (≥60 years). The Braden scale was used for the risk assessment of PI, and the epidemiological characteristics of PI were observed. The contributing factors of PI in older inpatients were examined using univariate and multiple or multivariable logistic regression analysis. The predictive validity and optimal cut-off value were assessed using receiver operating curve (ROC). The study included 13,064 older patients, with a PI incidence of 0.20%, with the highest incidence (0.95%) in those aged ≥80. Age, BMI, Braden score and length of hospital stay were related to PI occurrence. The Braden scale showed an AUC of 0.905 for predicting PI in older inpatients, with a sensitivity of 84.6% and specificity of 86.4%. The optimal cut-off value of 19 yielded the best predictive performance with a Yoden index of 0.710. PI is most likely to occur in older inpatients with older age, longer hospital stay, lower BMI and Braden score. The Braden scale demonstrated good suitability for predicting PI risk in this population, with an optimal cut-off value of 19 showing improved predictive accuracy. Throughout the investigation, patients or family members cooperated to complete all data investigation and evaluation, and nurses assisted in PI risk assessment, skin evaluation and other work.

Associations Between Dysphagia and Adverse Health Outcomes in Older Adults with Dementia in Intensive Care Units: A Retrospective Cohort Study.

Dysphagia is common in elderly patients with dementia and is one of the common clinical geriatric syndromes. It imposes a heavy burden on patients and their caregivers and is becoming an important public health problem. This study examined the association between dysphagia in older dementia patients in the ICU and the subsequent adverse health outcomes they experience. A retrospective analysis of adults (≥65 years) with dementia in ICUs of a Boston tertiary academic medical center was conducted. Using the International Classification of Diseases' Ninth and Tenth Revisions, dementia patients were identified. The study cohort comprised 1009 patients, median age 84.82 years, 56.6% female, predominantly White (72.9%). Patients were grouped based on swallowing function: dysphagia (n=282) and no-dysphagia (n=727). Dysphagia was identified via positive bedside swallowing screening. Primary outcomes were 90- and 180-day mortality, secondary outcomes included aspiration pneumonia, pressure injury, and delirium. Cohort characteristics were compared using the Wilcoxon rank-sum and chi-square tests. Dysphagia and outcomes correlations were examined via Kaplan-Meier survival analysis, Cox proportional-hazards regression models, logistic regression models, and subgroup analysis. After adjusting for covariates, the results from multivariate Cox proportional-hazards regression indicated that dysphagia was significantly associated with increased 90-day (HR=1.36, 95% CI=1.07-1.73, E-value=1.78) and 180-day (HR=1.47, 95% CI=1.18-1.82, E-value=1.94) mortality; the multifactorial logistic regression results indicated that dysphagia was associated with significant increases in pressure injury (OR=1.58, 95% CI=1.11-2.23, E-value=1.83) and aspiration pneumonia occurrence (OR=4.04, 95% CI=2.72-6.01, E-value=7.54), but was not significantly associated with delirium prevalence (OR=1.27, 95% CI=0.93-1.74). Dysphagia is likely to increase the risk of adverse health outcomes in older adults with dementia in ICU, and these adverse outcomes mostly include 90- and 180-day mortality, aspiration pneumonia, and pressure injury.

[Design and application of wrist restraint gloves suitable for patients with agitation].

Patients in the intensive care unit (ICU) often need to have various catheters placed on their bodies due to their severe condition. In order to prevent the occurrence of unplanned extubation, patients' hands should be restrained appropriately. The current restraint gloves used in clinical practice have problems such as improper restraint, easy falling off of oxygen saturation monitoring probes, and pressure injury of hands. Therefore, department of critical care medicine, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine designed a wrist restraint glove suitable for restless patients, and obtained the national utility model patent (ZL 2020 2 1612453.7). The device is composed of restraint gloves and restraint rings, which can not only restrain patients, but also continuously monitor the changes of blood oxygen saturation in patients with restfulness. This device is convenient to use, low cost, comfortable to wear, and can prevent the occurrence of device-related pressure injuries, which is suitable for clinical application.

Incidence and risk factors for pressure injury in hospitalized non-small cell lung cancer patients: A retrospective observational study

AimThis study aimed to identify the incidence and risk factors for pressure injury in patients hospitalized for non-small cell lung cancer (NSCLC). MethodsThis retrospective observational study was conducted in 645 adults who were hospitalized for NSCLC. Clinicopathological characteristics were compared between NSCLC patients with pressure injury and those without pressure injury. ResultsAmong total 645 patients, 180 patients showed pressure injury with an incidence of 27.9%. Patients with pressure injury showed increased serum C-reactive protein (CRP) levels (P < 0.001), increased neutrophil-lymphocyte ratio (P = 0.002), and increased platelet-lymphocyte ratio (P = 0.001) more often. Increase in serum CRP levels at the time of admission was the major risk factor for development of pressure injury in NSCLC patients (OR = 2.20; 95% CI [1.40–3.45]; P = 0.001). Also, among major inflammatory markers, serum CRP levels at the time of admission showed weak negative correlation with the period from admission to the development of pressure injury (r = −0.216, P = 0.004). ConclusionBy checking serum CRP levels at the time of admission, the NSCLC patients at high risk for the development of pressure injury can be identified in advance and the occurrence of pressure injury can be reduced by applying more active preventive nursing care. Clinical trial registration numberKCT0006570.

Characteristics and risk factors of facial pressure injuries in acute inpatients using noninvasive positive pressure ventilation: A retrospective case control study

ObjectiveTo explore the characteristics and risk factors of facial pressure injuries in patients using noninvasive positive pressure ventilation. Setting and samplePatients who developed facial pressure injuries due to non-invasive positive pressure ventilation at a teaching hospital in Taiwan from January 2016 to December 2021 were selected, resulting in a total of 108 patients in our case group. A control group was formed by matching each case by age and gender to three acute inpatients who had used non-invasive ventilation but had not developed facial pressure injuries, resulting in 324 patients in the control group. Research methodologyThis study was a retrospective case-control study. The characteristics of the patients who developed pressure injuries at different stages in the case group were compared, and the risk factors of non-invasive ventilation-related facial pressure injuries were then determined. ResultsHigher duration of non-invasive ventilation usage, higher length of hospital stay, lower Braden scale score, and lower albumin levels in the former group. The results of multivariate analysis from binary logistic regression involving the duration of non-invasive ventilation usage demonstrated that the patients who used this device for 4–9 days and 16 days were at greater risk of facial pressure injuries than those who used it for 3 days; in terms of the Braden scale score, higher Braden scale scores were correlated with a higher risk of facial pressure injuries. In addition, albumin levels lower than the normal range were correlated with a higher risk of facial pressure injuries. ConclusionPatients with pressure injuries at higher stages had a higher duration of non-invasive ventilation usage, higher length of hospital stay, lower Braden scale scores, and lower albumin levels. Thus, a longer duration of non-invasive ventilation use, lower Braden scale scores, and lower albumin levels were also risk factors for non-invasive ventilation-related facial pressure injuries. Implications for clinical practiceOur results serve as a useful reference for hospitals, both in creating training programs for their medical teams to prevent and treat facial pressure injuries and in drafting guidelines for assessing risk in order to prevent facial pressure injuries caused by non-invasive ventilation. The duration of device usage, Braden scale scores, and albumin levels in particular should be seriously monitored to reduce the occurrence of facial pressure injuries in acute inpatients treated with non-invasive ventilation.

Incidence of hospital acquired pressure injury in critically ill patients with COVID-19 in prone position admitted to the intensive care unit.

Critical patients have conditions that may favor the occurrence of hospital-acquired pressure injury (HAPI). The objective of this study was to identify the incidence and factors associated with the occurrence of HAPI in patients with coronavirus disease 2019 admitted to the intensive care unit (ICU) who used the prone position. Retrospective cohort study carried out in an ICU of a tertiary university hospital. Two hundred four patients with positive real-time polymerase chain reactions were evaluated, of which 84 were placed in the prone position. All patients were sedated and submitted to invasive mechanical ventilation. Of the prone patients, 52 (62%) developed some type of HAPI during hospitalization. The main place of occurrence of HAPI was the sacral region, followed by the gluteus and thorax. Of the patients who developed HAPI, 26 (50%) had this event in places possibly associated with the prone position. The factors associated with the occurrence of HAPI in patients prone to coronavirus disease 2019 were the Braden Scale and the length of stay in the ICU. The incidence of HAPI in prone patients was extremely high (62%), which denotes the need to implement protocols in order to prevent the occurrence of these events.

Respiratory device-related pressure injuries in hospitalised adults: An integrative review.

To identify the main ventilatory support medical devices related to the occurrence of pressure injuries in hospitalised adults, as well as the most frequent anatomical localisations of these injuries. The Integrative review was registered at Open Science Framework as per DOI 10.17605/OSF.IO/P3NTZ. Two independent reviewers, in May 2022, searched the databases: PubMed, Embase, Cochrane Database of Systematic Reviews, LILACS and CINAHL; no language or publication year restriction. The review question was: What are the ventilatory support medical devices that cause PIs in hospitalised adults more often? The terms for searching the database were: "adult," "noninvasive ventilation," "artificial respiration." and "pressure injury," and their synonyms. This review followed the PRISMA checklist. The final sample was 21 articles. Oxygen nasal catheters caused up to 40.7% of the pressure injuries by ventilatory support devices identified, all in the ears. Noninvasive mechanical ventilation oronasal masks presented an incidence of pressure injuries of 63.3%. The nasal bridge was the site most affected by this mask. The Set of Holders for Insight® endotracheal tubes was the device that caused the most pressure injuries, with an incidence of 75%, affecting lip commissure. Tracheostomy cannula accounted for 18.2% of the pressure injuries related to ventilatory support devices; all lesions were in the neck. The ventilatory support devices causing pressure injuries and the most affected sites were, respectively, nasal catheters, ears; masks, nasal bridge; endotracheal tubes, lip commissures; tracheostomy cannulas, neck. Knowing which respiratory devices cause pressure injuries more often in hospitalised adults and which anatomical localisations are more likely to be affected is fundamental for adopting preventive measures and reducing the occurrence of this problem. No patient or public contribution because of the review.

Pressure injury susceptibility related to lifestyle factors in patients with spinal cord injury: a cross-sectional survey

To identify the lifestyle factors preventing and predisposing to the development of pressure injuries (PIs) in individuals with spinal cord injury (SCI) living in the community in Bangladesh. A quantitative cross-sectional survey was conducted using a convenient sampling method. An equal number of participants, both with PIs and without, were recruited from the community, and a face-to-face interview was conducted. The standard outcome measure used to identify lifestyle factors in SCI was the Spinal Cord Injury Lifestyle Scale. The odds ratio (OR) was used to measure the associated difference between both groups and with sociodemographic variables. A p-value of ≤0.05 was considered statistically significant. The study cohort comprised 80 participants-40 with PIs and 40 without. The study findings showed that lifestyle factors that were strongly associated with the occurrence of PIs (p<0.01, OR: <1) were: smoking; regular exercise; weight-bearing activity; body position on wheelchair; joint contracture; skin examination; pressure relief technique; wearing a protective device; accessibility; bladder and bowel management (p=0.03, OR: 0.32). Whereas, bladder incontinence appeared as a strong risk factor (p=0.04, OR: 2.5) for developing PIs in people with SCI. The outcome of this study suggests that people with SCI should be aware of, and review, their lifestyle factors to reduce their chance of developing PIs.

Biomarkers and clinical features associated with pressure injury among geriatric patients

&lt;b&gt;Purpose:&lt;/b&gt; The study aims to identify biomarkers and clinical features associated with pressure injury (PI) among geriatric patients.&lt;br /&gt; &lt;b&gt;Methods:&lt;/b&gt; A cross-sectional study including 191 patients aged ≥60 years. Patients were classified into those with and without PI. Assessing the risk of PI was performed on admission by applying the Braden scale (BS) for predicting pressure sore risk. Clinical history, baseline hematology, and biochemistry results were obtained. C-reactive protein to albumin ratio (CAR) and Charlson comorbidity index (CCI) were calculated. Statistical analyses were performed.&lt;br /&gt; &lt;b&gt;Results: &lt;/b&gt;43 (22.5%) patients had PI. PI was significantly associated with higher CCI, total leukocyte count, and CAR, besides lower BS scores, serum albumin, and total proteins. Significant comorbidities were diabetes mellitus, stroke/transient ischemic attack, dementia, incontinence, and chronic kidney disease. The optimal cut-offs for PI occurrence were ≤14, ≤3.1 g/dl and &amp;gt;1.27 for BS, albumin, and CAR, respectively.

Prevalence of an insufficient vitamin D status at the onset of a spinal cord injury - a cross-sectional study.

A cross-sectional study. This study aimed to investigate the vitamin D status after acute spinal cord injury (SCI) onset. Specialized SCI rehabilitation center in Switzerland. Patients admitted to the center after an acute SCI onset were included. The prevalence of a deficient (25(OH)D ≤ 50 nmol/l), insufficient (50 < 25(OH)D ≤ 75 nmol/l) and sufficient (25(OH)D > 75 nmol/l) vitamin D status were determined after admission. Vitamin D status was compared between different patient groups based on demographic and SCI characteristics. The occurrence of bed rest, falls and pressure injuries were also assessed. In total, 87 patients (median (interquartile range); 53 (39-67) years, 25 females, 66 traumatic SCI, 54 paraplegia) were included. Assessed a median of 15 (9-22) days after SCI onset, median vitamin D status was 41 (26-57) (range 8-155) nmol/l. The majority of patients had a deficient (67%, 95% confidence interval (95% CI) 0.56-0.76) or insufficient (25%, 95% CI 0.17-0.36) vitamin D status. A moderate negative correlation was found between vitamin D status and body mass index (p = 0.003). A moderate positive correlation was found between vitamin D and calcium status (p = 0.01). A deficient or insufficient vitamin D status directly after SCI onset is highly prevalent. Vitamin D status should be carefully observed during acute SCI rehabilitation. We recommend that all patients with recent SCI onset should receive vitamin D supplementation with a dosage depending on their actual vitamin D status.