ABSTRACT
OBJETIVO: Determinar la incidencia de los distintos tipos de lesiones relacionadas con la dependencia (LRD) en una población de pacientes críticos. MÉTODO: Estudio descriptivo, longitudinal y prospectivo realizado en una Unidad de Cuidados Intensivos desde enero de 2014 a enero de 2015. Incluidos los pacientes mayores de edad que no presentaban LRD al ingreso. Excluidos aquellos con muerte encefálica y/o estancia en la unidad superior a dos días. Permanecieron en estudio hasta que desarrollaron LRD, fueron exitus, dados de alta o su estancia superior a 14 días. Cada paciente fue evaluado diariamente hasta desarrollar LRD o salida de estudio. En el caso de presentar LRD esta se fotografiaba y se anotaban los datos relacionados. La comparación entre variables cuantitativas de distribución normal se realizó mediante la t de Student, y se utilizó la U de Mann-Whitney en el resto. Entre variables cualitativas se utilizó el test chi cuadrado de Pearson considerándose en ambos casos significativa una p menos o igual a 0,05. RESULTADOS: Incluidos 295 pacientes, el 27,45% de los cuales desarrollaron LRD. La densidad de incidencia fue de 41 LRD/1.000 días en riesgo. El 50,62% de las LRD se catalogaron como UPP, el 17,28% fueron lesiones por humedad, el 13,58% lo fueron por fricción y el resto resultaron lesiones combinadas. El riesgo según las escalas EMINA y Braden fue significativamente superior en el grupo de pacientes con lesiones respecto al grupo sin ellas. CONCLUSIONES: No todas las lesiones fueron causadas por la presión. Se requieren estrategias preventivas específicas en función de los distintos mecanismos causales
AIM: To determine the incidence of various types of dependence-related lesions (DRL) on a population of critically ill patients. METHOD: Descriptive, longitudinal and prospective study in an Intensive Care Unit from January 2014 to January 2015. Adult patients who did not present DRL at the moment of admission were included. Those with brain death and/or stay at the unit for more than two days were excluded. Patients were studied till they developed DRL, were exitus, discharged or stayed for more than 14 days. Each patient was evaluated daily till DRL did develop or was excluded from the study. If DRL did develop it was photographed and related data were recorded. The comparison between quantitative variables of normal distribution was done with the t de Student. The Mann-Whitney U was used to compare the other variables. Qualitative variables were compared through Pearson's chi square. In both cases p less than or equal to 05 was considered significant. RESULTS: 295 patients were included, 27.45% of them developed DRL. The density of incidence was 41 DRL/1,000 days at risk.50.62% of DRL were categorized as PU.17.28% were moisture injuries, 13.58% were due to friction and the rest were combined injuries. The risk according to EMINA and Braden scale was significantly different in the group of patients with lesions compared to the group without them. CONCLUSIONS: Not all injuries were caused by pressure. Specific prevention strategies based on different causal mechanisms are required
Subject(s)
Humans , Pressure Ulcer/epidemiology , Intensive Care Units/statistics & numerical data , Skin Ulcer/epidemiology , Immobilization/adverse effects , Pressure Ulcer/nursing , Critical Care/methods , Friction , Prospective StudiesABSTRACT
AIM: To determine the incidence of various types of dependence-related lesions (DRL) on a population of critically ill patients. METHOD: Descriptive, longitudinal and prospective study in an Intensive Care Unit from January 2014 to January 2015. Adult patients who did not present DRL at the moment of admission were included. Those with brain death and/or stay at the unit for more than two days were excluded. Patients were studied till they developed DRL, were exitus, discharged or stayed for more than 14 days. Each patient was evaluated daily till DRL did develop or was excluded from the study. If DRL did develop it was photographed and related data were recorded. The comparison between quantitative variables of normal distribution was done with the t de Student. The Mann-Whitney U was used to compare the other variables. Qualitative variables were compared through Pearson's chi square. In both cases p≤.05 was considered significant. RESULTS: 295 patients were included, 27.45% of them developed DRL. The density of incidence was 41 DRL/1,000 days at risk. 50.62% of DRL were categorized as PU. 17.28% were moisture injuries, 13.58% were due to friction and the rest were combined injuries. The risk according to EMINA and Braden scale was significantly different in the group of patients with lesions compared to the group without them. CONCLUSIONS: Not all injuries were caused by pressure. Specific prevention strategies based on different causal mechanisms are required.
Subject(s)
Intensive Care Units , Pressure Ulcer , Humans , Incidence , Prospective Studies , Risk FactorsABSTRACT
Objetivo: clasificar y categorizar las lesiones relacionadas con la dependencia según la teoría de García-Fernández y cols. Metodología: estudio descriptivo y longitudinal realizado en una unidad de cuidados intensivos en el que se incluyó a todos los pacientes ingresados sin lesiones previas. Cada paciente fue evaluado diariamente hasta desarrollar una lesión relacionada con la dependencia o salida de estudio. Resultados: El 27,9% de los pacientes (n = 136) desarrollaron lesiones relacionadas con la dependencia, sin diferencias estadísticamente significativas entre pacientes que las desarrollaron y aquellos que no lo hicieron salvo para EMINA primer día (p = 0,035). Solo el 46,4% de las lesiones relacionadas con la dependencia se catalogaron como úlceras por presión. El 36,8% se relacionaron con dispositivos terapéuticos. Conclusiones: los resultados apoyan el cambio de paradigma propuesto por los autores, lo que permite diferenciar entre úlceras por presión y otro tipo de lesiones
Aim: Descriptive to clasified and categorize the dependence related lesions on the theory García-Fernández y cols. Metodology: Descriptive and longitudinal study in intensive care unit in which all patients admitted. We included patients without previous pressure ulcers. Each patient was assessed daily to develop dependence related lesions or output study. Results: 27.9% of patients (n = 136) developed dependence related lesions. No statistically significant differences between patients who developed dependence related lesions and those who did not save for EMINA first day (p = 0.035). Only 46.4% of dependence related lesions were classified as pressure ulcers. 36.8% were related to medical devices. Conclusions: Our results support the paradigm shift proposed by these authors allowing differentiation between pressure ulcers and other lesions
Subject(s)
Adult , Female , Humans , Male , Pressure Ulcer/epidemiology , Pressure Ulcer/etiology , Pressure Ulcer/prevention & control , Epidemiological Monitoring/trends , Mobility Limitation , Intensive Care Units , Friction , Humidity , Length of Stay , Hospitalization , Equipment and Supplies , Spain/epidemiologyABSTRACT
El objetivo de este estudio fue valorar la fiabilidad interobservador de las escalas EMINA y EVARUCI en una unidad de cuidados intensivos. Para ello, dos observadores valoraron diariamente el riesgo de desarrollar úlceras por presión mediante ambas escalas. La concordancia entre observadores para la puntuación total de las escalas se midió mediante el coeficiente de correlación intraclase (CCI) y la concordancia entre subescalas con el índice de Kappa. La fiabilidad total interobservador fue muy buena para EMINA, (CCI = 0,92) y para EVARUCI (CCI = 0, 99). En la escala EMINA el ítem nutrición presentó concordancia pobre (k = 0,137), mientras que las subescalas restantes presentaron concordancia buena. En la escala EVARUCI todas las subescalas mostraron buena concordancia
The aim of this study was to evaluate the interobserver reliability of the scales EMINA and EVARUCI in Intensive Care Unit. To this day two observers assessed the risk of developing pressure ulcers by EMINA and EVARUCI scales in all patients admitted. The interobserver agreement for the total score EVARUCI and EMINA was measured by intraclass correlation coefficient (ICC). The agreement between the subscales was measured by Kappa. The overallinter observer reliability was very good for EMINA scale (ICC =0.92) and EVARUCI (ICC = 0.99). In item scale Nutrition EMINA presented poor agreement (k = 0.137) while the remaining subscales showed good agreement. On the scale EVARUCI all subscales showed very good agreement
