Determination of Pressure Injury Risk Factors in COVID-19 Patients Hospitalized in the Intensive Care Unit

Abstract

Objective: This study aimed to determine the risk factors for pressure injury in COVID-19 in intensive care unit. Materials and Methods: A retrospective study was conducted using COVID-19 Intensive Care Unit archive data from April 2020 to July 2022. The study included patients aged 18 and over, with no pre-existing pressure injury, at high risk (Braden Score not between 6-12), and hospitalized in the ICU for at least 24 hours. Results: A pressure injury developed in 25.2% of the patients. Among those who developed a pressure injury, 79.4% were classified as Stage I, characterized by redness, and 36.8% of the injuries occurred in the sacral region. A significant difference was observed in relation to age, length of stay, Braden score, albumin levels, hemoglobin levels, oxygen levels, and medications used between patients with pressure injuries and those without (p <0.05). The Braden scale was used for risk assessment. Factors independently associated with pressure injury were hemoglobin (1.398 [1.122-1.742]), hemoglobin (0.067 [0.007-0.643]), high-dose steroids (0.026 [0.002-0.317]) and oxygen (0.108 [0.012-0.964]). Conclusions: It was found that stage I developed in patients, and the most pressure injuries were in the sacrum. The risk of pressure injury was associated with the Braden score, hemoglobin, high-dose steroids, and oxygen. Nurses should evaluate the risk of developing pressure injury in the intensive care unit. They should minimize the conditions that will threaten the safety of patients at risk.

Keywords

• COVID-19
• intensive care unit
• pressure injury
• risk factors

Yoğun Bakım Ünitesinde Yatan COVID-19 Hastalarının Basınç Yaralanması Risk Faktörlerinin Belirlenmesi

Öz

Amaç: Bu çalışmanın amacı yoğun bakım ünitesinde COVID-19'a bağlı bası yarası risk faktörlerini belirlemektir. Materyal ve Metot: Nisan 2020 ile Temmuz 2022 tarihleri ​​arasında COVID-19 yoğun bakım arşiv verileri kullanılarak retrospektif bir çalışma gerçekleştirildi. Çalışmaya 18 yaş ve üzeri, önceden mevcut basınç yarası olmayan, yüksek risk altında olan (Braden Skoru 6-12 puan arasında olmayan) ve en az 24 saat yoğun bakımda yatan hastalar dâhil edildi. Bulgular: Bir basınç yarası, hastaların %25.2'sinde gelişti. Basınç yarası gelişenlerin %79.4'ü, kızarıklıkla karakterize edilen Evre I olarak sınıflandırıldı ve yaraların %36.8'i sakral bölgede meydana geldi. Basınç yarası olan ve olmayan hastalar arasında yaş, yatış süresi, Braden skoru, albümin seviyesi, hemoglobin düzeyi, oksijen seviyesi ve kullanılan ilaçlarla ilgili anlamlı bir fark gözlendi (p<0.05). Risk değerlendirmesi için Braden ölçeği kullanıldı. Basınç yaralanmasıyla bağımsız olarak ilişkili faktörler (1,398 [1,122-1,742]), hemoglobin (0,067 [0,007-0,643]), yüksek doz steroid (0,026 [0,002-0,317]) ve oksijen (0,108 [0,012-0,964]) bulundu. Sonuç: Hastalarda evre I geliştiği ve en fazla basınç yaralanmasının sakrumda olduğu bulundu. Basınç yaralanması riski Braden skoru, hemoglobin, yüksek doz steroid ve oksijen ile ilişkiliydi. Hemşireler yoğun bakım ünitesinde basınç yaralanması gelişme riskini değerlendirmelidir. Risk altındaki hastaların güvenliğini tehdit edecek koşulları en aza indirmelidirler.

Anahtar Kelimeler

• Basınç yaralanması
• COVID-19
• risk faktörleri
• yoğun bakım ünitesi

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