• KSAN
  • Contact us
  • E-Submission

Korean J Adult Nurs : Korean Journal of Adult Nursing

OPEN ACCESS
mobile search button mobile menu button
Search
Advanced Search
ABOUT
BROWSE ARTICLES
EDITORIAL POLICY
FOR CONTRIBUTORS

Articles

Page Path

Original Article

Pressure Ulcer Prevalence and Risk Factors at the Time of Intensive Care Unit Admission

Hye Ran Kwak1, Jiyeon Kang2
Korean Journal of Adult Nursing 2015;27(3):347-357.
Published online: June 30, 2015

1Dong-A University Medical Center, CCU, Busan

2Department of Nursing, Dong-A University, Busan, Korea

Corresponding author: Kang, Jiyeon Department of Nursing, Dong-A University, 1 Dongdaesin-dong 3-ga, Seo-gu, Busan 602-714, Korea. Tel: +82-51-240-2871, Fax: +82-51-240-2920, E-mail: jykang@dau.ac.kr
• Received: April 14, 2015   • Accepted: June 8, 2015

Copyright © 2015 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

  • 39 Views
  • 1 Download
  • 14 Crossref
  • 15 Scopus
prev next

Full Article

Download PDF Download PDF
  • Purpose
    This study was conducted to assess the prevalence rate of, and the risk factors for pressure ulcers in critical patients at the time of intensive care unit (ICU) admission.
  • Methods
    We reviewed the electronic medical records of 2,107 patients who were admitted to the intensive care units in D university hospital between January 1 and December 31, 2012. The collected date were analyzed by x2-test, t-test, and multi-variate logistic regression with forward stepwise selection using the SPSS program version 21.
  • Results
    The prevalence rate of pressure ulcers at the ICU admission was 23.7%. Risk factors significantly affecting pressure ulcers carrying were the age of 80 years or older (OR=3.70, 95% CI: 1.80~7.60), body weight less than 50 kg (OR=2.82, 95% CI: 1.74~4.56), sedated consciousness (OR=6.10, 95% CI: 3.57~10.40), use of ventilator (OR=1.60, 95% CI: 1.02~2.49), use of vasopressors (OR=1.53, 95% CI: 1.09~2.14), ICU admission via operation room (OR=0.49, 95% CI: 0.29~0.85), and hospital admission from nursing homes (OR=13.65, 95% CI: 3.02~61.72).
  • Conclusion
    The findings of this study suggested that the prevention efforts for pressure ulcers should be given in prior to ICU admission. Further research is necessary for developing nursing interventions for preventing pressure ulcers in the pre-ICU stage.
  • Key Words: Pressure ulcer; Prevalence; Risk factors; Intensive care units; Patient admission
Table 1.
Prevalence of Pressure Ulcers at the ICU Admission
Types of ICU Admitted patients Pressure ulcers carrying patients Prevalence (%)
n (%) n (%)
Mixed 637 (31.2) 215 (43.0) 33.8
Neurological 569 (27.0) 116 (23.2) 20.4
Cardiac 901 (47.8) 169 (33.8) 18.8
Total 2,107 (100.0) 500 (100.0) 23.7

ICU=intensive care unit.

Table 2.
The Demographic and Disease-related Characteristics of the Subjects (N=1,024)
Variables Categories PU group (n=408) Non-PU group (n=616) x2 or t p
n (%) or M±SD n (%) or M±SD
Gender Male 240 (58.8) 359 (58.3) 0.03 .863
Female 168 (41.2) 257 (41.7)
Age (year) ＜40 23 (5.6) 53 (8.6) 25.62 ＜.001
40~60 90 (22.1) 191 (31.0) 4.81 ＜.001
60~80 222 (54.4) 316 (51.3)
≥80 73 (17.9) 56 (9.1)
  66.14±14.51 61.64±14.78
Body weight (kg) ＜50 89 (21.8) 61 (9.9) 33.95 ＜.001
50~60 110 (27.0) 157 (25.5)
60~70 128 (31.4) 216 (35.1)
≥70 81 (19.9) 182 (29.5)
  58.78±11.62 63.29±10.91 6.32 ＜.001
Main disease Respiratory 46 (11.3) 40 (6.5) 24.37 .004
Circulatory 131 (32.1) 229 (37.2)
Liver 4 (1.0) 9 (1.5)
Kidney 38 (9.3) 34 (5.5)
Neurological 101 (24.8) 171 (27.8)
Sepsis 13 (3.2) 17 (2.8)
Gastrointestinal 15 (3.7) 24 (3.9)
Cancer 22 (5.4) 57 (9.3)
Metabolic 10 (2.5) 8 (1.3)
Others 28 (6.9) 27 (4.4)
ICU types Mixed 161 (39.5) 155 (25.2) 23.87 ＜.001
Neurological 105 (25.7) 207 (33.6)
Cardiac 142 (34.8) 254 (41.2)
KHNA severity IV (62~92) 0 (0.0) 1 (0.2) 37.90 ＜.001
V (93~141) 260 (63.7) 497 (80.7)
VI (≥142) 148 (36.3) 118 (19.2)

PU=pressure ulcers; ICU=intensive care unit; KHNA=Korean hospital nurses association.

Table 3.
Comparison of Personal Risk Factors between PU Group and Non-PU Group (N=1,024)
Variables Categories PU group (n=408) Non-PU group (n=616) x2 or t p
n (%) or M±SD n (%) or M±SD
Consciousness Alert 57 (14.0) 223 (36.2) 106.28 ＜.001
Drowsy 121 (29.7) 222 (36.0)
Stupor 74 (18.1) 76 (12.3)
Semicoma 20 (4.9) 17 (2.8)
Coma 17 (4.2) 10 (1.6)
Sedation 119 (29.2) 68 (11.0)
Hypertension Yes 251 (61.5) 360 (58.4) 0.97 .326
No 157 (38.5) 256 (41.6)
Diabetes Yes 301 (73.8) 472 (76.6) 1.08 .299
No 107 (26.2) 144 (23.4)
Other comorbidities Yes 321 (78.7) 426 (69.2) 11.27 .001
No 87 (21.3) 190 (30.8)
Albumin (g/dL) ＜2.9 98 (24.0) 61 (9.9) 77.06 ＜.001
2.9~3.3 170 (41.7) 180 (29.2)
≥3.4 140 (34.3) 375 (60.9)
CRP (mg/dL) ≤0.5 63 (15.8) 144 (23.6) 9.23 .002
＞0.5 337 (84.3) 465 (76.4)
Hb (mg/dL) ＜Standard† 270 (66.2) 314 (51.0) 23.15 ＜.001
≥Standard† 138 (33.8) 302 (49.0)
Body temperature (℃) ＜36 99 (24.3) 178 (28.9) 10.41 .015
36.1~37.0 218 (53.4) 347 (56.3)
37.1~38.0 67 (16.4) 64 (10.4)
≥38.1 24 (5.9) 27 (4.4)
Braden scale score   11.27±2.39 13.28±2.70 12.52 ＜.001

PU=Pressure ulcers; CRP=C-reactive protein; Hb=Hemoglobin;

†Male=13 mg/dL, Female=11 mg/dL.

Table 4.
Comparison of Institutional Risk Factors between PU Group and Non-PU Group (N=1,024)
Variables Categories PU group (n=408) Non-PU group (n=616) x2 or t p
n (%) or M±SD n (%) or M±SD
Ventilator Yes 240 (58.8) 275 (44.6) 19.74 ＜.001
No 168 (41.2) 341 (55.4)
CRRT Yes 0 (0.0) 1 (0.2) 0.66 .416
No 408 (100.0) 615 (99.8)
Hypothermia therapy Yes 5 (1.2) 7 (1.1) 0.02 .897
No 403 (98.8) 609 (98.9)
Restraints Yes 41 (10.0) 38 (6.2) 5.19 .023
No 367 (90.0) 578 (93.8)
Vasopressors Yes 198 (48.5) 189 (30.7) 33.25 ＜.001
No 210 (51.5) 427 (69.3)
Sedatives Yes 199 (48.8) 253 (41.1) 5.91 .015
No 209 (51.2) 363 (58.9)
ICU admission route ED 197 (48.6) 292 (48.2) 6.45 .040
OR 132 (32.6) 232 (38.3)
GW 76 (18.8) 82 (13.5)
Hours of hospital stay prior to ICU admission ≤6 126 (32.1) 325 (53.9) 65.66 ＜.001
7~12 79 (20.2) 117 (19.4)
13~24 53 (13.5) 49 (8.1)
25~48 48 (12.2) 48 (8.0)
≥49 86 (21.9) 64 (10.6)
  55.98±149.25 38.90±136.62 1.88 .061
Surgery Yes 146 (35.8) 236 (38.3) 0.67 .413
No 262 (64.2) 380 (61.7)
Hospital admission route Local hospital 195 (49.4) 275 (45.8) 35.28 ＜.001
Nursing home 26 (6.6) 3 (0.5)
Home 174 (44.1) 322 (53.7)

CRRT=continuous renal replacement therapy; ED=emergency department; GW=general ward; ICU=intensive care units; OR=operating room; PU=pressure ulcers.

Table 5.
Multi-variate Analysis of Risk factors for Carrying Pressure Sores at the ICU Admission (N=1,024)
Variables Categories Standardized Odds ratio p x2 (p)
B SE Exp (B) 95% CI
Age (year) ＜40 ref. 　 　   .002 202.93
40~60 0.53 .33 1.70 0.89~3.23 .106 (＜.001)
60~80 0.73 .31 2.07 1.12~3.83 .020
≥80 1.31 .37 3.70 1.80~7.60 ＜.001
Body weight (kg) ＜50 1.04 .25 2.82 1.74~4.56 ＜.001
50~60 0.39 .21 1.47 0.98~2.21 .065
60~70 0.31 .20 1.36 0.92~2.00 .119
≥70 ref. 　 　   ＜.001
Consciousness Alert ref. 　 　   ＜.001
Drowsy 0.77 .22 2.16 1.41~3.29 ＜.001
Stupor 1.25 .25 3.50 2.14~5.71 ＜.001
Semicoma 1.17 .40 3.22 1.47~7.08 .004
Coma 1.52 .47 4.57 1.82~11.48 .001
Sedation 1.81 .27 6.10 3.57~10.40 ＜.001
Ventilator   0.47 .23 1.60 1.02~2.49 .040
Vasopressors   0.42 .17 1.53 1.09~2.14 .015
ICU admission route ED 0.06 .22 1.06 0.69~1.65 .790
OR -0.71 .28 0.49 0.29~0.85 .010
GW ref. 　 　   .003
Hospital admission route Local hospital l 0.10 .16 1.11 0.81~1.51 .514
Nursing home e 2.61 .77 13.65 3.02~61.72 .001
Home ref. 　 　   .003

PU=pressure ulcers; ICU=intensive care units; ED=emergency department; OR=operating room; GW=general ward.

  • 1.Bansal C, Scott R, Stewart D, Cockerell CJ. Decubitus ulcers: a review of the literature. International Journal of Dermatology. 2005;44(10):805-10. http://dx.doi.org/10.1111/j.1365-4632.2005.02636.x.
  • 2.Cho CH, Jun KJ, Bok S, Hong JH, Lee H, Park NK, et al. Epidemiologic study on clinical features of patient with pressure ulcer: a prospective study. Journal of Korean Academy of Rehabilitation Medicine. 2005;29(1):122-7.
  • 3.Im M, Park H. A study on the pressure ulcers in neurological patients in intensive care units. Journal of Korean Academy of Fundamentals of Nursing. 2006;13(2):190-9.
  • 4.Slowikowski GC, Funk M. Factors associated with pressure ulcers in patients in a surgical intensive care unit. Journal of Wound, Ostomy & Continence Nursing. 2010;37(6):619-26. http://dx.doi.org/10.1097/WON.0b013e3181f90a34.
  • 5.Kaitani T, Tokunaga K, Matsui N, Sanada H. Risk factors related to the development of pressure ulcers in the critical care setting. Journal of Clinical Nursing. 2010;19(3-4):414-21. http://dx.doi.org/10.1111/j.1365-2702.2009.03047.x.
  • 6.Kim EJ, Han NS, Park JY, Lee SB, Do BS, Kim SB, et al. A stay time optimization model emergency medical center (EMC). Journal of Korean Academic Society of Home Health Care Nursing. 2011;18(2):81-7.
  • 7.Hwang HY, Shin YS, Cho HS, Yeo JS. Risk factors of pressure sore in patients undergoing general anesthesia. Korean Journal of Anesthesiology. 2007;53(1):79-84.
  • 8.Manzano F, Navarro MJ, Roldán D, Moral MA, Leyva I, Guerrero C, et al. Pressure ulcer incidence and risk factors in ventilated intensive care patients. Journal of Critical Care. 2010;25(3):469-76. http://dx.doi.org/10.1016/j.jcrc.2009.09.002.
  • 9.Curry K, Kutash M, Chambers T, Evans A, Holt M, Purcell S. A prospective, descriptive study of characteristics associated with skin failure in critically ill adults. Ostomy Wound Management. 2012;58(5):36-43.
  • 10.Lee HN, Park JS. Nutritional-related factors predicted pressure ulcers in intensive care unit patients. Journal of Korean Academy of Fundamentals of Nursing. 2014;21(4):413-22. http://dx.doi.org/10.7739/jkafn.2014.21.4.413.
  • 11.Shahin ES, Dassen T, Halfens RJ. Pressure ulcer prevalence and incidence in intensive care patients: a literature review. Nursing in Critical Care. 2008;13(2):71-9. http://dx.doi.org/10.1111/j.1478-5153.2007.00249.x.
  • 12.Shahin ES, Dassen T, Halfens RJ. Incidence, prevention and treatment of pressure ulcers in intensive care patients: a longitudinal study. International Journal of Nursing Studies. 2009;46(4):413-21. http://dx.doi.org/10.1016/j.ijnurstu.2008.02.011.
  • 13.Kim KN, Kang KJ, Lee HS, Shin YH, Kim SK, Park KH, et al. Survey on pressure ulcers and influencing factors of stage change in acute university hospital inpatients. Journal of Korean Clinical Nursing Research. 2011;17(3):433-42.
  • 14.Park HS, Park KY, Ryu SM. Factors influencing the development of pressure ulcers in surgical patients. Journal of Korean Academy of Nursing. 2005;35(1):125-34.
  • 15.Tschannen D, Bates O, Talsma A, Guo Y. Patient-specific and surgical characteristics in the development of pressure ulcers. American Journal of Critical Care. 2012;21(2):116-25. http://dx.doi.org/10.4037/ajcc2012716.
  • 16.Nijs N, Toppets A, Defloor T, Bernaerts K, Milisen K, Van Den Berghe G. Incidence and risk factors for pressure ulcers in the intensive care unit. Journal of Clinical Nursing. 2009;18(9):1258-66. http://dx.doi.org/10.1111/j.1365-2702.2008.02554.x.
  • 17.European Pressure Ulcer Advisory Panel & National Pressure Ulcer Advisory Panel. Pressure ulcer prevention quick reference guide [internet]. Washington, DC: European Pressure Ulcer Advisory Panel & National Pressure Ulcer Advisory Panel; 2009. [cited 2015 March 23]. Available from:.http://www.epuap.org/guidelines/guidelines-old/.
  • 18.Kim KS, Kim JA, Kim MS, Kim YJ, Kim ES, Park KD, et al. Development of performance measures based on the nursing process for prevention and management of pressure ulcers, falls and pain. Journal of Korean Clinical Nursing Research. 2009;15(1):133-47.
  • 19.Cox J. Predictors of pressure ulcers in adult critical care patients. American Journal of Critical Care. 2011;20(5):364-75. http://dx.doi.org/10.4037/ajcc2011934.
  • 20.Keelaghan E, Margolis D, Zhan M, Baumgarten M. Prevalence of pressure ulcers on hospital admission among nursing home residents transferred to the hospital. Wound Repair and Regeneration. 2008;16(3):331-6. http://dx.doi.org/10.1111/j.1524-475X.2008.00373.x.
  • 21.Terekeci H, Kucukardali Y, Top C, Onem Y, Celik S, Oktenli C. Risk assessment study of the pressure ulcers in intensive care unit patients. European Journal of Internal Medicine. 2009;20(4):394-7. http://dx.doi.org/10.1016/j.ejim.2008.11.001.
  • 22.Hyun S, Li X, Vermillion B, Newton C, Fall M, Kaewprag P, et al. Body mass index and pressure ulcers: improved predictability of pressure ulcers in intensive care patients. American Journal of Critical Care. 2014;23(6):494-500. http://dx.doi.org/10.4037/ajcc2014535.
  • 23.Kim JA, Kim KS. Preventive strategies of ventilator associated pneumonia. Journal of Korean Critical Care Nursing. 2009;2(2):42-55.
  • 24.Jang HJ, Na SW, Oh BJ, Lim CM, Ko YS, Hong SB. Multicenter prospective observational study about the usage patterns of sedatives, analgesics and neuromuscular blocking agents in the patients requiring more than 72 hours mechanical ventilation in intensive care units of Korea. The Korean Journal of Critical Care Medicine. 2009;24(3):145-51.
  • 25.Klompas M, Anderson D, Trick W, Babcock H, Kerlin MP, Li L, et al. The preventability of ventilator-associated events. The CDC prevention epicenters wake up and breathe collaborative. American Journal of Respiratory and Critical Care Medicine. 2015;191(3):292-301. http://dx.doi.org/10.1164/rccm.201407-1394OC.
  • 26.Tayyib N, Coye F, Lewis P. Pressure ulcers in the adult intensive care unit: a literature review of patient risk factors and risk assessment scales. Journal of Nursing Education and Practice. 2013;3(11):28-42. http://dx.doi.org/10.5430/jnep.v3n11p28.
  • 27.Webster J, Lister C, Corry J, Holland M, Coleman K, Marquart L. Incidence and risk factors for surgically acquired pressure ulcers: a prospective cohort study investigators. Journal of Wound Ostomy and Continence Nursing. 2015;42(2):138-44. http://dx.doi.org/10.1097/WON.0000000000000092.
  • 28.Kwong EW, Pang SM, Aboo GH, Law SS. Pressure ulcer development in older residents in nursing homes: influencing factors. Journal of Advanced Nursing. 2009;65(12):2608-20. http://dx.doi.org/10.1111/j.1365-2648.2009.05117.x.
  • 29.Shin KL, Kim MY, Kang YH, Jung DY, Cha JY, Lee E, et al. Facility and nursing factors influence on pressure ulcer occurrence among patients at risk for pressure ulcer in long-term care hospitals. Journal of Korean Gerontological Nursing. 2012;14(1):30-9.
  • 30.Jeong IS, Kim S, Jeong JS, Hong EY, Lim EY, Seo HJ, et al. Development of pressure ulcer management guideline by adaptation process. Journal of Korean Clinical Nursing Research. 2014;20(1):40-52.

Figure & Data

References

    Citations

    Citations to this article as recorded by  
    • Factors aggravating the stage of pressure injury in dyspneic patients
      Jung Eun Hong, Mi-Ock Shim, Heejung Choi, Yeongju Been, Seungmi Park
      Journal of Tissue Viability.2025; 34(3): 100898.     CrossRef
    • Aetiology, risk factors and treatment of typical and atypical pressure ulcers in patients with traumatic brain injury: A narrative review
      Mohammadreza Dehghani, Hossein Pourmontaseri
      International Wound Journal.2024;[Epub]     CrossRef
    • The effect of support surface on the prevention of pressure injury in acute care settings: A multi-center prospective observational study
      Mi-Ock Shim, Chul-Gyu Kim, Ja Kyung Min, So Yeon Kwak, Hyunhee Ghil, Seungmi Park
      Journal of Tissue Viability.2024; 33(4): 652.     CrossRef
    • Development of a Pressure Injury Machine Learning Prediction Model and Integration into Clinical Practice: A Prediction Model Development and Validation Study
      Ju Hee Lee, Jae Yong Yu, So Yun Shim, Kyung Mi Yeom, Hyun A Ha, Se Yong Jekal, Ki Tae Moon, Joo Hee Park, Sook Hyun Park, Jeong Hee Hong, Mi Ra Song, Won Chul Cha
      Korean Journal of Adult Nursing.2024; 36(3): 191.     CrossRef
    • Evaluating the Knowledge Levels and Attitudes Regarding Pressure Injuries among Nurses in Turkey
      Seda Şahan, Sevil Güler
      Advances in Skin & Wound Care.2024; 37(9): 1.     CrossRef
    • Characteristics and Risk Factors for Pressure Ulcers in Severe Trauma Patients Admitted to the Trauma Intensive Care Unit
      Seung-yeon Lim, Young-min Jeong, So-young Jeong
      Journal of Acute Care Surgery.2023; 13(2): 47.     CrossRef
    • Risk Factors Associated With Pressure Ulcers in Patients With Traumatic Brain Injury Admitted to the Intensive Care Unit
      Jeong Eun Yoon, Ok-Hee Cho
      Clinical Nursing Research.2022; 31(4): 648.     CrossRef
    • Factors Associated with Pressure Injury Among Critically Ill Patients in a Coronary Care Unit
      Eunji Ko, Seunghye Choi
      Advances in Skin & Wound Care.2022; 35(10): 1.     CrossRef
    • Differences in Associated Factors according to the Time of Occurrence of Pressure Ulcers in Intensive Care Unit Patients
      Mijung Lee, Eunjeoung Seo, Miok Kim, Jeongok Park, Seonmi Lee, Hyunkyung Shin, Ilsim Yun, Mina Cho, Youngcha Cho, Bomi Kang, Hyunmi Seo, Misoon Lee, Sira Lee, Hyejoo Jang, Hyunsuk Jung, Jeong-Ah Ahn
      Journal of Korean Critical Care Nursing.2021; 14(3): 26.     CrossRef
    • The effect of uncoated paper application on skin moisture, risk of pressure injury and incidence of pressure injury in neurologic intensive care unit patients: A randomized controlled trial
      Yoo‐Hyung Choi, Sung Reul Kim
      International Journal of Nursing Practice.2021;[Epub]     CrossRef
    • Risk Factors of Medical Device-Related Pressure Ulcer in Intensive Care Units
      MiJee Koo, YoungA Sim, InSoon Kang
      Journal of Korean Academy of Nursing.2019; 49(1): 36.     CrossRef
    • Use of prophylactic silicone adhesive dressings for maintaining skin integrity in intensive care unit patients: A randomised controlled trial
      Yun J. Lee, Jung Y. Kim, Woo Y. Shin
      International Wound Journal.2019; 16(S1): 36.     CrossRef
    • Medical device‐related pressure ulcer (MDRPU) in acute care hospitals and its perceived importance and prevention performance by clinical nurses
      Jung Yoon Kim, Yun Jin Lee
      International Wound Journal.2019; 16(S1): 51.     CrossRef
    • Factors Predicting the Interface Pressure Related to Pressure Injury in Intensive Care Unit Patients
      Ji Seon Shine, Soo Jin Kim, Ji Hyun Lee, Mi Yu
      Journal of Korean Academy of Nursing.2017; 47(6): 794.     CrossRef

    Download Citation

    Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.

    Format:

    Include:

    Pressure Ulcer Prevalence and Risk Factors at the Time of Intensive Care Unit Admission
    Korean J Adult Nurs. 2015;27(3):347-357.   Published online June 30, 2015
    DOI: https://doi.org/10.7475/kjan.2015.27.3.347
    Download Citation
    Download a citation file in RIS format that can be imported by all major citation management software, including EndNote, ProCite, RefWorks, and Reference Manager.
    Format:
    • RIS — For EndNote, ProCite, RefWorks, and most other reference management software
    • BibTeX — For JabRef, BibDesk, and other BibTeX-specific software
    Include:
    • Citation for the content below
    Pressure Ulcer Prevalence and Risk Factors at the Time of Intensive Care Unit Admission
    Korean J Adult Nurs. 2015;27(3):347-357.   Published online June 30, 2015
    DOI: https://doi.org/10.7475/kjan.2015.27.3.347
    Close
    Pressure Ulcer Prevalence and Risk Factors at the Time of Intensive Care Unit Admission
    Pressure Ulcer Prevalence and Risk Factors at the Time of Intensive Care Unit Admission

    Prevalence of Pressure Ulcers at the ICU Admission

    Types of ICU Admitted patients Pressure ulcers carrying patients Prevalence (%)
    n (%) n (%)
    Mixed 637 (31.2) 215 (43.0) 33.8
    Neurological 569 (27.0) 116 (23.2) 20.4
    Cardiac 901 (47.8) 169 (33.8) 18.8
    Total 2,107 (100.0) 500 (100.0) 23.7

    ICU=intensive care unit.

    The Demographic and Disease-related Characteristics of the Subjects (N=1,024)

    Variables Categories PU group (n=408) Non-PU group (n=616) x2 or t p
    n (%) or M±SD n (%) or M±SD
    Gender Male 240 (58.8) 359 (58.3) 0.03 .863
    Female 168 (41.2) 257 (41.7)
    Age (year) ＜40 23 (5.6) 53 (8.6) 25.62 ＜.001
    40~60 90 (22.1) 191 (31.0) 4.81 ＜.001
    60~80 222 (54.4) 316 (51.3)
    ≥80 73 (17.9) 56 (9.1)
      66.14±14.51 61.64±14.78
    Body weight (kg) ＜50 89 (21.8) 61 (9.9) 33.95 ＜.001
    50~60 110 (27.0) 157 (25.5)
    60~70 128 (31.4) 216 (35.1)
    ≥70 81 (19.9) 182 (29.5)
      58.78±11.62 63.29±10.91 6.32 ＜.001
    Main disease Respiratory 46 (11.3) 40 (6.5) 24.37 .004
    Circulatory 131 (32.1) 229 (37.2)
    Liver 4 (1.0) 9 (1.5)
    Kidney 38 (9.3) 34 (5.5)
    Neurological 101 (24.8) 171 (27.8)
    Sepsis 13 (3.2) 17 (2.8)
    Gastrointestinal 15 (3.7) 24 (3.9)
    Cancer 22 (5.4) 57 (9.3)
    Metabolic 10 (2.5) 8 (1.3)
    Others 28 (6.9) 27 (4.4)
    ICU types Mixed 161 (39.5) 155 (25.2) 23.87 ＜.001
    Neurological 105 (25.7) 207 (33.6)
    Cardiac 142 (34.8) 254 (41.2)
    KHNA severity IV (62~92) 0 (0.0) 1 (0.2) 37.90 ＜.001
    V (93~141) 260 (63.7) 497 (80.7)
    VI (≥142) 148 (36.3) 118 (19.2)

    PU=pressure ulcers; ICU=intensive care unit; KHNA=Korean hospital nurses association.

    Comparison of Personal Risk Factors between PU Group and Non-PU Group (N=1,024)

    Variables Categories PU group (n=408) Non-PU group (n=616) x2 or t p
    n (%) or M±SD n (%) or M±SD
    Consciousness Alert 57 (14.0) 223 (36.2) 106.28 ＜.001
    Drowsy 121 (29.7) 222 (36.0)
    Stupor 74 (18.1) 76 (12.3)
    Semicoma 20 (4.9) 17 (2.8)
    Coma 17 (4.2) 10 (1.6)
    Sedation 119 (29.2) 68 (11.0)
    Hypertension Yes 251 (61.5) 360 (58.4) 0.97 .326
    No 157 (38.5) 256 (41.6)
    Diabetes Yes 301 (73.8) 472 (76.6) 1.08 .299
    No 107 (26.2) 144 (23.4)
    Other comorbidities Yes 321 (78.7) 426 (69.2) 11.27 .001
    No 87 (21.3) 190 (30.8)
    Albumin (g/dL) ＜2.9 98 (24.0) 61 (9.9) 77.06 ＜.001
    2.9~3.3 170 (41.7) 180 (29.2)
    ≥3.4 140 (34.3) 375 (60.9)
    CRP (mg/dL) ≤0.5 63 (15.8) 144 (23.6) 9.23 .002
    ＞0.5 337 (84.3) 465 (76.4)
    Hb (mg/dL) ＜Standard† 270 (66.2) 314 (51.0) 23.15 ＜.001
    ≥Standard† 138 (33.8) 302 (49.0)
    Body temperature (℃) ＜36 99 (24.3) 178 (28.9) 10.41 .015
    36.1~37.0 218 (53.4) 347 (56.3)
    37.1~38.0 67 (16.4) 64 (10.4)
    ≥38.1 24 (5.9) 27 (4.4)
    Braden scale score   11.27±2.39 13.28±2.70 12.52 ＜.001

    PU=Pressure ulcers; CRP=C-reactive protein; Hb=Hemoglobin;

    †Male=13 mg/dL, Female=11 mg/dL.

    Comparison of Institutional Risk Factors between PU Group and Non-PU Group (N=1,024)

    Variables Categories PU group (n=408) Non-PU group (n=616) x2 or t p
    n (%) or M±SD n (%) or M±SD
    Ventilator Yes 240 (58.8) 275 (44.6) 19.74 ＜.001
    No 168 (41.2) 341 (55.4)
    CRRT Yes 0 (0.0) 1 (0.2) 0.66 .416
    No 408 (100.0) 615 (99.8)
    Hypothermia therapy Yes 5 (1.2) 7 (1.1) 0.02 .897
    No 403 (98.8) 609 (98.9)
    Restraints Yes 41 (10.0) 38 (6.2) 5.19 .023
    No 367 (90.0) 578 (93.8)
    Vasopressors Yes 198 (48.5) 189 (30.7) 33.25 ＜.001
    No 210 (51.5) 427 (69.3)
    Sedatives Yes 199 (48.8) 253 (41.1) 5.91 .015
    No 209 (51.2) 363 (58.9)
    ICU admission route ED 197 (48.6) 292 (48.2) 6.45 .040
    OR 132 (32.6) 232 (38.3)
    GW 76 (18.8) 82 (13.5)
    Hours of hospital stay prior to ICU admission ≤6 126 (32.1) 325 (53.9) 65.66 ＜.001
    7~12 79 (20.2) 117 (19.4)
    13~24 53 (13.5) 49 (8.1)
    25~48 48 (12.2) 48 (8.0)
    ≥49 86 (21.9) 64 (10.6)
      55.98±149.25 38.90±136.62 1.88 .061
    Surgery Yes 146 (35.8) 236 (38.3) 0.67 .413
    No 262 (64.2) 380 (61.7)
    Hospital admission route Local hospital 195 (49.4) 275 (45.8) 35.28 ＜.001
    Nursing home 26 (6.6) 3 (0.5)
    Home 174 (44.1) 322 (53.7)

    CRRT=continuous renal replacement therapy; ED=emergency department; GW=general ward; ICU=intensive care units; OR=operating room; PU=pressure ulcers.

    Multi-variate Analysis of Risk factors for Carrying Pressure Sores at the ICU Admission (N=1,024)

    Variables Categories Standardized Odds ratio p x2 (p)
    B SE Exp (B) 95% CI
    Age (year) ＜40 ref. 　 　   .002 202.93
    40~60 0.53 .33 1.70 0.89~3.23 .106 (＜.001)
    60~80 0.73 .31 2.07 1.12~3.83 .020
    ≥80 1.31 .37 3.70 1.80~7.60 ＜.001
    Body weight (kg) ＜50 1.04 .25 2.82 1.74~4.56 ＜.001
    50~60 0.39 .21 1.47 0.98~2.21 .065
    60~70 0.31 .20 1.36 0.92~2.00 .119
    ≥70 ref. 　 　   ＜.001
    Consciousness Alert ref. 　 　   ＜.001
    Drowsy 0.77 .22 2.16 1.41~3.29 ＜.001
    Stupor 1.25 .25 3.50 2.14~5.71 ＜.001
    Semicoma 1.17 .40 3.22 1.47~7.08 .004
    Coma 1.52 .47 4.57 1.82~11.48 .001
    Sedation 1.81 .27 6.10 3.57~10.40 ＜.001
    Ventilator   0.47 .23 1.60 1.02~2.49 .040
    Vasopressors   0.42 .17 1.53 1.09~2.14 .015
    ICU admission route ED 0.06 .22 1.06 0.69~1.65 .790
    OR -0.71 .28 0.49 0.29~0.85 .010
    GW ref. 　 　   .003
    Hospital admission route Local hospital l 0.10 .16 1.11 0.81~1.51 .514
    Nursing home e 2.61 .77 13.65 3.02~61.72 .001
    Home ref. 　 　   .003

    PU=pressure ulcers; ICU=intensive care units; ED=emergency department; OR=operating room; GW=general ward.
    Table 1. Prevalence of Pressure Ulcers at the ICU Admission

    ICU=intensive care unit.

    Table 2. The Demographic and Disease-related Characteristics of the Subjects (N=1,024)

    PU=pressure ulcers; ICU=intensive care unit; KHNA=Korean hospital nurses association.

    Table 3. Comparison of Personal Risk Factors between PU Group and Non-PU Group (N=1,024)

    PU=Pressure ulcers; CRP=C-reactive protein; Hb=Hemoglobin;

    Male=13 mg/dL, Female=11 mg/dL.

    Table 4. Comparison of Institutional Risk Factors between PU Group and Non-PU Group (N=1,024)

    CRRT=continuous renal replacement therapy; ED=emergency department; GW=general ward; ICU=intensive care units; OR=operating room; PU=pressure ulcers.

    Table 5. Multi-variate Analysis of Risk factors for Carrying Pressure Sores at the ICU Admission (N=1,024)

    PU=pressure ulcers; ICU=intensive care units; ED=emergency department; OR=operating room; GW=general ward.

    Table 1.

    Table 2.

    Table 3.

    Table 4.

    Table 5.

    Korean J Adult Nurs : Korean Journal of Adult Nursing

    ABOUT

    BROWSE ARTICLES 

    EDITORIAL POLICY

    FOR CONTRIBUTORS  

    © Korean Society of Adult Nursing.
    TOP