Effects of hemoglobin and albumin levels on the development of pressure ulcers in inpatients in intensive care clinics

Year 2022, , 71 - 78, 30.04.2022

Elçin Efteli

https://doi.org/10.24998/maeusabed.1091135

Abstract

Pressure sores are accepted as an indicator of inadequate care all over the world. It also prolongs the length of hospital stay and increases the rates of mortality and morbidity. In our study, the effects of hemoglobin and albumen values on the development of pressure ulcers were investigated. The sample of the descriptive study consisted of 68 adults over the age of 18 who were hospitalized in intensive care clinics between November 2021 and March 2022. The mean age of the patients included in the study was 67.08±14.35 years. Of them, 42.6% were women, 17.6% were intubated, and 57.4% had the normal state of consciousness. The rate of pressure ulcer development in patients was 26.5%. In our study, it was determined that hemoglobin and albumin values in patients with pressure ulcers hospitalized in intensive care clinics were lower than those without pressure ulcers, and the difference was statistically significant.

Keywords

Pressure Sore, Hemoglobin, Albumin

Yoğun Bakım Kliniklerinde Yatan Hastalarda Hemoglobin ve Albümin Değerlerinin Basınç Yarası Gelişimine Etkisi

Abstract

Bası yaraları tüm dünyada bakımın yetersizliğinin bir göstergesi olarak kabul edilmektedir. Ayrıca hastanede yatış süresini uzatmakta ve mortalite ve morbitide oranlarını da arttırmaktadır. Çalışmamızda hemoglobin ve albümün değerlerini basınç yarası gelişimi üzerine olan etkisi incelenmiştir. Tanımlayıcı tipte olan araştırmanın örneklemini Kasım 2021 – Mart 2022 tarihleri arasında yoğun bakım kliniklerinde yatan 18 yaş üzeri 68 yetişkin birey oluşturdu. Çalışma kapsamına alınan hastaların yaş ortalamalarının 67.08±14.35, %42.6’sının kadın, %17.6’sının entübe, %57.4’ünün normal bilinç düzeyine sahip olduğu belirlendi. Hastalarda basınç yarası gelişme oranı %26.5’dir. Çalışmamızda yoğun bakım kliniklerinde yatan, bası yarası gelişen hastalarda hemoglobin ve albümin değerlerinin bası yarası gelişmeyen hastalara göre daha düşük olduğu ve farkın istatistiksel olarak anlamlı olduğu belirlenmiştir.

Keywords

Bası Yarası, Hemoglobin, Albümin

References

• Alaca, R., Hazneci, B., Göktepe, S., Gündüz, Ş., Kalyon, T.A., 2001. Spinal kord hasarlılarda bası yarası gelişimi için risk faktörleri. Gülhane Tıp Dergisi 43(1), 25-29.
• Anthony, D., Rafter, L., Reynolds, T., Aljezawi, M., 2011. An evaluation of serum albumin and the sub-scores of the Waterlow score in pressure ulcer risk assessment. Journal of Tissue Viability. 20(3), 89–99
• Artico, M., Dante, A., D’Angelo, D., Lamarca, L., Mastroianni, C., Petitti, T., De Marinis, M.G., 2018. Prevalence, incidence and associated factors of pressure ulcers in home palliative care patients: A retrospective chart review. Palliative Medicine 32(1), 299–307.
• Bahar, A., Özgürbüz, N.E., 2022. Validity and reliability of the Turkish version of The Pressure Injury Prevention Knowledge Questionnaire (PIPK). Journal of Tissue Viability 31(1), 30-37.
• Bly, D., Schallom, M., Sona, C., Klinkenberg, D., 2016. A model of pressure, oxygenation, and perfusion risk factors for pressure ulcers in the ıntensive care unit. American Journal of Critical Care 25(2), 156–164.
• Bouillanne, O., Hay, P., Liabaud, B., Duché, C., Cynober, L., Aussel, C., 2011. Evidence that albumin is not a suitable marker of body composition-related nutritional status in elderly patients. Nutrition 27(2),165–169.
• Brito, P.A., Generoso, S.V., Correia, M., 2013. Prevalence of pressure ulcers in hospitals in Brazil and association with nutritional status: a multicenter, crosssectional study. Nutrition 29, 646–649. https://doi.org/10.1016/j.nut.2012.11.008.
• Coleman, S., Gorecki, C., Nelson, E.A., Closs, S.J., Defloor, T., Halfens, R., Nixon, J., 2013. Patient risk factors for pressure ulcer development: Systematic review. International Journal of Nursing Studies 50(7),974–1003.
• Çelik, S., 2016. Characteristics of patients hospitalized in the intensive care units of the university hospital: a retrospective analysis between 2009 and 2013. Journal of Intensive Care Nursing 20(2), 71–79.
• Çınar, F., Kula, S., Şahin, S., Eti Aslan, F., 2018. Evaluation of studies in Turkey on the prevention of pressure sores in the intensive care unit: a systematic review. Balıkesir Health Sciences Journal 7(1), 42–50. https://doi.org/10.5505/bsbd.2018.6025.
• Dorner, B., Posthauer, M.E., Thomas, D., 2009. The role of nutrition in pressure ulcer prevention and treatment: National Pressure Ulcer Advisory Panel white paper 22(5),10.
• Efteli, E., Güneş, Ü., 2020. Assessing the validity and reliability of a new pressure ulcer risk assessment scale for patients in ıntensive care units. Wound Management & Prevention 66(2), 24-33.
• Ersoy, E.O, Öcal, S., Öz, A., Yılmaz, P., Arsava, B., Topeli, A., 2013. Yoğun bakım hastalarında bası yarası gelişiminde rol oynayabilecek risk faktörlerinin değerlendirilmesi. Yoğun Bakım Dergisi 4(1), 9-12.
• European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel and Pan Pacific Pressure Injury Alliance. Basınç Ülserlerinin/Yaralarının Önlenmesi ve Tedavisi: Hızlı Başvuru Kılavuzu 2019. (Türkçe versiyon). Emily Haesler (Ed.).EPUAP/NPIAP/PPPIA: 2019.
• Fogerty, M.D, Abumrad, N.N., Nanney, L., Arbogast, P.G, Poulose, B., Barbul, A., 2008. Risk factors for pressure ulcers in acute care hospitals. Wound Repair and Regeneration 16(1), 11-18.
• Fuoco, U., Scivoletto, G., Pace, A., Vona, V.U., Castellano, V., 1997. Anaemia and serum protein alteration in patients with pressure ulcers. Spinal Cord 35 (1), 58-60.
• Gencer, Z.E., Ünal, E., Özkan, Ö., 2018. The cost analysis of pressure ulcer treatment; the treatment cost comparison of conventional and modern. Wound Care 12(1), 1–8. https://doi.org/10.17954/amj.2018.1099.
• Girgin Kelebek, N., Erarı Kurhan, G., 2007. Bası yarası bakımı. Türk Yoğun Bakım Derneği Dergisi 5, 11–13.
• Gunningberg, L., Lindholm, C., Carlsson, M., Sjödén, P.O., 2001. Risk, prevention and treatment of pressure ulcers-nursing staff knowledge and documentation. Scandinavian Journal of Caring Sciences 15(3), 257-263.
• Gül, Y.G., Köprülü, A.S., Haspolat, A., Uzman, S., Toptas, M., Kurtulus, İ., 2016. Braden Risk Değerlendirme Skalası yoğun bakım ünitesinde tedavi gören 3.düzey hastalarda basınç ülseri oluşumu riskini değerlendirmekte güvenilir ve yeterli mi? Journal of Academic Research in Medicine 6(2), 98–104. https:// doi.org/10.5152/jarem.2016.969
• Halfens, R., Van Achterberg, T., Bal, R., 2000. Validity and reliability of the Braden scale and the influence of other risk factors: a multicentre prospective study. International Journal of Nursing Studies 37, 313-9.
• Hatanaka, N., Yamamoto, Y., Ichihara, K., Mastuo, S., Nakamura, Y., Watanabe, M., Iwatani, Y., 2008. A new predictive indicator for development of pressure ulcers in bedridden patients based on common laboratory tests results. Journal of Clinical Pathology 61(4), 514–518.
• İnan, D.G., Öztunç, G., 2012. Pressure ulcer prevalence in Turkey: a sample from a university hospital. Journal of Wound Ostomy & Continence Nursing 39(4), 409–413. https://doi.org/10.1097/WON.0b013e31825825b1.
• İnözü, E., Özakpınar, H. R., Durgun, M., Eryılmaz, A. T, Selçuk, C. T, Tellioğlu, A.T., 2012. Geriatrik hastalarda bası yaralarına yaklaşım. Dicle Tıp Dergisi 39(3), 408-412.
• Jaul, E., 2001. Pressure sores unit- a one year study. Harefuah, 140 (10), 903-906
• Kalmann, U., Suserud, B.O., 2008. Knowledge, attitudes and practice among nursing staff concerning pressure ulcer prevention and treatment-a survey in a Swedish healthcare setting. Scandinavian Journal of Caring Sciences23(2), 121–129. https://doi.org/10.1111/j.1471-6712.2008.00627
• Katran, H.B., 2015. Bir cerrahi yoğun bakım ünitesi’nde bası yarası görülme sıklığı ve bası yarası gelişimim etkileyen risk faktörlerinin irdelenmesi. Journal of Academic Research in Nursing 1(1), 8–14. https://doi.org/10.5222/ jaren.2015.008
• Kıraner, E., Terzi, B., Ekinci Uzun, A., Tunalı, B., 2016. Yoğun bakım ünitemizdeki basınç yarası insidansı ve risk faktörlerinin belirlenmesi. Yoğun Bakım Hemşireliği Dergisi 20(2), 78–83.
• Kottner, J., Peytavi, U.V., 2021. Reliability and agreement of instrumental skin barrier measurements in clinical pressure ulcer prevention research. International Wound Journal 1–12. https://doi.org/10.1111/iwj.13574
• Kurtuluş, Z., Pınar, R., 2003. Braden Skalası ile belirlenen yüksek riskli hasta grubunda albümin düzeyleri ile bası yaraları arasındaki ilişki. C.Ü. Hemşirelik Yüksek Okulu Dergisi 7(2), 1-10
• Landi, F., Russo, A., Danese, P., Liperoti, R., Barillaro, C., Bernabei, R., Onder, G., 2007. Anemia status, hemoglobin concentration, and mortality in nursing home older residents. Journal of the American Medical Directors Association 8(5), 322–327.
• Langemo, D., Haesler, E., Naylor, W., Tippett, A., Young, T., 2015. Evidence-based guidelines for pressure ulcer management at the end of life. International Journal of Palliative Nursing 21(5), 225–232.
• Lindgren, M., Unosson, M., Fredrikson, M., Ek, A.C., 2004. Immobility – a major risk factor for development of pressure ulcers among adult hospitalized patients: a prospective study. Scandinavian Journal of Caring Sciences 18(1), 57–64.
• National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel, Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline. Haesler E, editor. Osborne Park, Western Australia: Cambridge Media; 2014.
• Neziraj, M., Hellman, P., Kumlien, C., Andersson, M., Axelsson, M., 2021. Prevalence of risk for pressure ulcers, malnutrition, poor oral health and falls – a register study among older persons receiving municipal health care in southern Sweden. BMC Geriatrics 21(1), 265–275. https://doi.org/10.1186/s12877-021-02205-x.
• Ortaç Ersoy, E., Öcal, S., Öz, A., Yılmaz, P., Arsava, B., Topeli, A., 2013. Yoğun bakım hastalarında bası yarası gelişimde rol oynayabilecek risk faktörlerinin değerlendirilmesi. Yoğun Bakım Dergisi 4(1), 9–12. https://doi.org/10.5152/dcbybd.2013.03
• Perneger, T.V., Rae, A.C., Gaspoz, J.M., Borst, F., Vitek, O., Heliot, C., 2002. Screening for pressure ulcer risk in an acute care hospital: development of a brief bedside scale. Journal of Clinical Epidemiology 55(5), 498–504.
• Pressure ulcers prevention: quıck reference guıde. https://www.epuap.org/w p-content/uploads/2016/10/qrg_prevention_in_turkish.pdf. [accessed 28 Semptember 2021
• Serpa, L., Santos, V., Campanili, T., Queiroz, M., 2011. Predictive validity of the Braden scale for pressure ulcer risk in critical care patients. Revista Latino-Americana de Enfermagem 19(1), 50-57
• Serra, R., Caroleo, S., Buffone, G., Lugarà, M., Molinari, V., Tropea, F., de Franciscis, S., 2014. Low serum albümin level as an independent risk factor for the onset of pressure ulcers in intensive care unit patients. International Wound Journal 11(5), 550–553.
• Stephen-Haynes, J., 2012. Pressure ulceration and palliative care: prevention, treatment, policy and outcomes. International Journal of Palliative Nursing 18(1), 9–16.
• Sugino, H., Hashimoto, I., Tanaka, Y., Ishida, S., Abe, Y., Nakanishi, H., 2014. Relation between the serum albumin level and nutrition supply in patients with pressure ulcers: retrospective study in an acute care setting. The Journal of Medical Investigation 61(1.2), 15–21
• Taylor, C., 2017. Importance of nutrition in preventing and treating pressure ulcers. Nursing Older People 29(6), 33–39
• Terekeci, H., Kucukardali, Y., Top, C., Onem, Y., Celik, S., Öktenli, Ç., 2009. Risk assessment study of the pressure ulcers in intensive care unit patients. European Journal of Internal Medicine 20(4), 394-397.
• Tokgöz, O.S., Demir, O., 2010. Nöroloji yoğun bakım ünitesinde bası yara insidansı ve risk faktörleri. Selçuk Üniversitesi Tıp Dergisi 26(3), 95–98.
• Tosun, Z.K., Bölüktaş, R.P., 2015. Yoğun bakım ünitelerindeki yaşlı hastalarda bası yarası prevalansı ve etkileyen faktörler. Yoğun Bakım Hemşireliği Dergisi 19(2), 43–53.
• Tsaras, K., Chatzi, M., Kleisiaris, C., Fradelos, E., Kourkouta, L., Papathanasiou, I., 2016. Pressure ulcers: developing clinical ındicators in evidence-based practice. a prospective study. Medical Archives 70(5), 379.
• Turgut, N., Ak, A., Yakar, N., Yılmaz, B., Cora, B., Mıngır, T., Ali, İ., 2017. yoğun bakım hastalarında basınç ülseri sıklığı, önlenmesi ve tedavisi. Türk Yoğun Bakım Derneği Dergisi 15(2), 72–76. https://doi.org/10.4274/tybdd.84755
• Ullah,, N., Alam, I., 2012. Nutritional care of patients with pressure ulcers: Some evidence based guidelines. Pakistan Journal of Medical Sciences 28(1), 196-200
• Ülker Efteli, E., Yapucu Günes, Ü., 2013. A prospective, descriptive study of risk factors related to pressure ulcer development among patients in intensive care units. Ostomy Wound Management. 59(7), 22–7.
• Wanderwee, K., Grypdonck, M., Bacquer, D.D., DeFloor, T., 2009. The identification of older nursing home residents vulnerable for deterioration of grade 1 pressure ulcers. Journal of Clinical Nursing 18(21), 3050–3058.
• Williams, D.F., Stotts, N.A., Nelson, K., 2001. Patients with existing pressure ulcers admitted to acute care. Journal of Wound Ostomy Continence Nursing 28 (1), 36.