Yoğun Bakım Ünitesinden İç Hastalıkları Kliniğine Devir Olan Hastalardaki Basınç Ülseri Sıklığı ve İlişkili Risk Faktörleri

Year 2023, , 324 - 330, 20.12.2023

Mustafa Keleş , Mehmet Uzunlulu , Cündullah Torun

https://doi.org/10.46332/aemj.1207025

Abstract

Amaç: Bu çalışmanın amacı yoğun bakım ünitelerinden (YBÜ) iç hastalıkları kliniklerine devir olan hastalardaki basınç ülseri sıklığının belirlenmesi ve basınç ülseri ile ilişkili klinik özelliklerin araştırılmasıdır.

Araçlar ve Yöntem: Prospektif, gözlemsel çalışmaya iç hastalıkları kliniklerine YBÜ’den devir olan 18 yaş ve üzeri 100 hasta ardışık olarak alındı. Olguların YBÜ’ye yatış esnasındaki nutrisyonel risk skoru (NRS-2002) ve BRADEN ölçeği ile iç hastalıkları kliniklerine devir esnasındaki basınç ülseri sıklığı, lokalizasyonu ve evresi belirlendi. Basınç ülseri olan ve olmayan hastalar klinik ve laboratuvar özelliklerine göre karşılaştırıldı.

Bulgular: Çalışmaya alınan 100 hastanın 52’si (%52) kadındı. Ortalama yaş 69.8±16.5 yıl bulundu. İç hastalıkları kliniğine devir esnasında basınç ülseri sıklığı %50, en sık basınç ülseri lokalizasyonu sakrum (%88), en sık basınç ülseri evresi evre 2 (%58) idi. Basınç ülseri olanlarda olmayanlara göre; yaş ortalaması (sırasıyla 74±13, 66±18; p=0.022), YBÜ yatış süresi (p<0.001), serebrovasküler hastalık ve demansı olan (sırasıyla p=0.016 ve p<0.001), invasif mekanik ventilasyon, pozitif inotrop ajan ve antibiyotik kullanılan (sırasıyla p<0.001, p=0.005 ve p=0.008), YBÜ yatışı öncesi basınç ülseri olan (p<0.001), malnütrisyon risk skoru ve BRADEN ölçeği ile belirlenen basınç ülseri riski artmış bulunan (p<0.001) hasta sıklığı yüksekti. Lojistik regresyon analizinde YBÜ yatış süresindeki 1 günlük artışın basınç ülseri riskini 1.42 kat artırdığı görüldü.

Sonuç: Bu çalışma YBÜ’den iç hastalıkları kliniklerine devir olan her iki hastadan birinde basınç ülserinin mevcut olduğunu ve YBÜ yatış süresi uzadıkça basınç ülseri gelişme riskinin arttığını ortaya koymuştur.

Keywords

NRS-2002 skoru, Braden Ölçeği, Hareketsizlik

Frequency of Pressure Ulcers and Related Risk Factors in Patients Transferred From the Intensive Care Unit to the Internal Diseases Clinic

Abstract

Purpose: Determination of pressure ulcer frequency and pressure ulcer-related clinical features in patients transferred from intensive care units (ICU) to internal medicine clinics.

Material and Methods: A prospective, observational study included 100 consecutive patients aged 18 years and older. Nutritional risk score (NRS-2002) and BRADEN scale at admission to the intensive care unit were calculated. During the transfer to the internal medicine clinic, the frequency, localization and stage of pressure ulcers were determined. Patients with and without pressure ulcers were compared according to clinical and laboratory characteristics.

Results: Of the 100 patients included in the study, 52 (52%) were women. The mean age was 69.8±16.5 years. The frequency of pressure ulcer was 50%, the most common location and stage was sacrum (88%), and stage 2 (58%). The mean age (74±13, 66±18 respectively, p=0.022) and length of stay in ICU (p<0.001) were higher in patients with pressure ulcer. Those with cerebrovascular disease and dementia (p=0.016 and p<0.001 respectively), using invasive mechanical ventilation, positive inotropic agents and antibiotics (p<0.001, p=0.005, and p=0.008, respectively), with pressure ulcer before ICU (p<0.001), high risk of malnutrition and pressure ulcer (p<0.001) were more common in patients with pressure ulcer. It was seen that 1 day increase in ICU length of stay increased the risk of pressure ulcer 1.42 times.

Conclusion: This study revealed that half of the patients transferred from the ICU to the internal medicine clinics had pressure ulcer, and the risk of developing pressure ulcers increases as the length of stay in the ICU is prolonged.

Keywords

NRS-2002 Score, Braden Scale, Immobilization

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