Yoğun bakımda takip edilen COVID-19 hastalarında bası yarası gelişimi ve risk faktörlerinin değerlendirilmesi

Year 2023, , 288 - 295, 30.08.2023

Ozlemoner Öner , Mehmet Çağatay Gürkök , Mehmet Nuri Yakar , Begüm Ergan , Erdem Yaka , Necati Gökmen

https://doi.org/10.47582/jompac.1316995

Abstract

Amaç:
Bu çalışmada, yoğun bakım ünitesinde takip edilen COVID-19 hastalarında basınç yarası gelişiminin nedenlerini değerlendirmek amaçlanmıştır.

Yöntemler:
Hastaların demografik verileri, eşlik eden hastalıklar, laboratuvar parametreleri, tedavi yöntemleri ve mortalite oranları hastane kayıtlarından retrospektif olarak incelendi. Ayrıca, Akut Fizyoloji ve Kronik Sağlık Değerlendirme (APACHE II), Sıralı Organ Yetmezlik Değerlendirme (SOFA) ve modifiye NUTRIC skorları hesaplandı. Basınç yarası değerlendirmesi için Braden ölçeği kullanıldı.

Bulgular:
Çalışmaya seksen COVID-19 hastası dahil edildi. Vakaların 29'unda (%36,25) basınç yarası tespit edilirken, 51'inde (%63,75) basınç yarası tespit edilmedi. Hastaların 54'ü (%69,7) erkek, 26'sı (%32,5) kadın ve ortalama yaş 69 (61-77) idi. Vakalar, basınç yarası gelişimine göre iki gruba ayrıldı. APACHE II skoru PU grubunda 24 (17-29) iken, PU olmayan grupta 18 (12-23) idi (p=0,01); mNUTRIC skoru PU grubunda 4 (3-5) iken, PU olmayan grupta 3 (2-4) idi (p=0,023); yoğun bakıma kabulde hesaplanan Braden ölçeği skoru PU grubunda 11 (10-13) iken, PU olmayan grupta 14 (12-15) idi (p<0,001). Braden ölçeği skoru <13 olan hasta sayısı PU grubunda 22 (%75,9) iken, PU olmayan grupta 14 (%27,5) ve toplamda 36 (%45) hastada bulundu (p<0,001).

Sonuç:
COVID-19 hastalarında Braden Ölçeği, yoğun bakıma ilk kabul edildikleri için hem yaranın skorlanması hem de prognozun hızlı bir şekilde tahmin edilmesi için kullanılabilir.

Keywords

COVID-19, Basınç yarası, Yoğun bakım ünitesi, Braden Ölçeği, Mortalite

Evaluation of pressure ulcer development and risk factors in COVID-19 patients followed in the ICU

Abstract

Aims: In this study it was aimed to evaluate the causes of pressure ulcer development in COVID-19 patients followed in the intensive care unit (ICU).
Methods: Demographic data, comorbidities, laboratory parameters, treatment modalities and mortality rates of the patients were reviewed retrospectively from hospital records. In addition, Acute Physiology and Chronic Health Assessment (APACHE II), Sequential Organ Failure Assessment (SOFA), and modified NUTRIC scores were calculated. Braden scale was used for pressure ulcer evaluation.
Results: Eighty COVID-19 patients were included in the study. Pressure ulcers (PU) were detected in 29 (36.25%) of the cases, and no pressure ulcer was detected in 51 (63.75%) cases. 54 (69.7%) of the patients were male, 26 (32.5%) were female, and the mean age was 69 (61-77). The cases were divided into two groups according to the development of pressure ulcers. The APACHE II score was 24 (17-29) in the PU group and 18 (12-23) in the non-PU group (p=0.01), the mNUTRIC score was 4 (3-5) in the PU group and 3 (2-4) in the non-PU group.) (p=0.023), the Braden scale calculated at admission to the ICU was 11(10-13) in the PU group and 14(12-15) (p<0.001) in the non-PU group. A Braden scale score of <13 was found to be 22 (75.9) in the PU group and 14 (27.5) in the non-PU group, and 36 (45) patients in total (p<0.001).
Conclusion: The Braden Scale can be used in COVID-19 patients, since they are first admitted to the ICU, both for scoring the wound and predicting the (making a) prognosis quickly.

Keywords

COVID-19, Pressure Ulcer, ICU, Braden Scale, Mortality

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