TY - JOUR T1 - Determination of Pressure Injury Risk Factors in COVID-19 Patients Hospitalized in the Intensive Care Unit TT - Yoğun Bakım Ünitesinde Yatan COVID-19 Hastalarının Basınç Yaralanması Risk Faktörlerinin Belirlenmesi AU - Tura, Ilknur AU - Üstünel, Fatmagül AU - Erden, Sevilay PY - 2025 DA - September Y2 - 2025 DO - 10.26453/otjhs.1664017 JF - Online Turkish Journal of Health Sciences JO - OTSBD PB - Oğuz KARABAY WT - DergiPark SN - 2459-1467 SP - 232 EP - 238 VL - 10 IS - 3 LA - en AB - 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 KW - COVID-19 KW - intensive care unit KW - pressure injury KW - risk factors N2 - 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 CR - Erden S, Artiklar T, Tura İ, Türkmen A. Assessment of procedural pain in patients with COVID-19 in the intensive care unit. Pain Manag Nurs. 2022;23(5):596-601. doi:10.1016/j.pmn.2022.03.002 CR - Alhazzani W, Møller MH, Arabi YM, et al. Surviving sepsis campaign: Guidelines on the management of critically ill adults with coronavirus disease 2019 (COVID-19). Crit Care Med. 2020;48(6):440-469. doi:10.1097/CCM.0000000000004363 CR - Phua J, Weng L, Ling L, et al; Asian Critical Care Clinical Trials Group. Intensive care management of coronavirus disease 2019 (COVID-19): Challenges and recommendations. Lancet Respir Med. 2020;8(5):506-517. doi:10.1016/S2213-2600(20)30161-2 CR - Şengül T, Erden S, Karadağ A, Yılmaz D, Gökduman T. Overlooked pain assessment records in patients with pressure injuries during the COVID-19 pandemic: A retrospective data analysis. Adv Skin Wound Care. 2024;37(3):162-166. CR - McEvoy NL, Friel O, Clarke J, et al. Pressure ulcers in patients with COVID-19 acute respiratory distress syndrome undergoing prone positioning in the intensive care unit: A pre- and post-intervention study. Nurs Crit Care. 2023;28(6):1115-1123 doi:10.1111/nicc.12842. CR - Trevellini C. Challenges faced with morbidity obese patients during COVID-19. The 2020 Virtual Meeting of the European Pressure Ulcer Advisory Panel (EPUAP). https://www.epuap.org/wp-content/uploads/2020/09/epuap2020-virtual-abstract-book.qxp_sestava-1.pdf. Accessed October 2020. CR - Aksoy M, Büyükbayram Z. The prevalence, characteristics, and related factors of pressure injury in medical staff wearing personal protective equipment against COVID-19 in Turkey: A multicenter cross-sectional study. J Tissue Viability. 2022;31(2):207-212. doi:10.1016/j.jtv.2022.03.004 CR - Kavutlu M, Engin E, Şenol D, Karacan A. COVID-19 hastalarında prone pozisyonunun tedavi seyri üzerine etkisi. Turk J Intensive Care. 2022;20:252. CR - Hadaya J, Benharash P. Prone positioning for acute respiratory distress syndrome (ARDS). JAMA. 2020;324(13):1361. doi:10.1001/jama.2020.14901 CR - Lucchini A, Bambi S, Mattiussi E, et al. Prone Position in Acute Respiratory Distress Syndrome Patients: A Retrospective Analysis of Complications. Dimens Crit Care Nurs. 2020;39(1):39-46. doi:10.1097/DCC.0000000000000393 CR - Moore Z, Patton D, Avsar P, et al. Prevention of pressure ulcers among individuals cared for in the prone position: lessons for the COVID-19 emergency. J Wound Care. 2020;29(6):312-320. doi:10.12968/jowc.2020.29.6.312 CR - Kıraner E, Kaya H. Covid-19 tanısı ile yoğun bakımda yatan hastalarda basınç yaralanmalarının ve risk faktörlerinin retrospektif analizi. Yoğun Bakım Hemşireliği Dergisi. 202;25(3):139-151. CR - Bergstrom N, Demuth PJ, Braden BJ. A clinical trial of the Braden Scale for predicting pressure sore risk. Nurs Clin North Am. 1989;22(2):417-428. CR - Oğuz S, Olgun N. Braden Ölçeği ile hastaların risklerinin belirlenmesi ve planlı hemşirelik bakımının bası yaralarının önlenmesindeki etkinliğinin saptanması. Hemsirelikte Arastirma Gelistirme Dergisi. 1997;2(1):131-135. CR - Bourkas AN, Zaman M, Sibbald RG. COVID-19 and Hospital-Acquired Pressure Injuries: A Systematic Review. Adv Skin Wound Care. 2023;36(8):421-434. doi:10.1097/ASW.0000000000000005 CR - Beyene RT, Derryberry SL Jr, Barbul A. The effect of comorbidities on wound healing. Surg Clin North Am. 2020;100(4):695-705. doi:10.1016/j.suc.2020.05.002 CR - Huang J, Cheng A, Kumar R, et al. Hypoalbuminemia predicts the outcome of COVID-19 independent of age and co-morbidity. J Med Virol. 2020;92(10):2152-2158. doi:10.1002/jmv.26003 CR - Lampersberger LM, Bauer S, Osmancevic S. Prevalence of falls, incontinence, malnutrition, pain, pressure injury, and restraints in home care: A narrative review. Health Soc Care Community. 2022;30(6):e3656-e3669. doi:10.1111/hsc.14021 CR - Hoffmeister B, Aguilar Valdez AD. Elevated admission C-reactive protein to albumin ratios are associated with disease severity and respiratory complications in adults with imported falciparum malaria. Trans R Soc Trop Med Hyg. 2022;116(5):492-500. doi:10.1093/trstmh/trab167 CR - Tura İ, Arslan S, Türkmen A, Erden S. Assessment of the risk factors for intraoperative pressure injuries in patients. J Tissue Viability. 2023;32(3):349-354. doi:10.1016/j.jtv.2023.04.006 CR - Anthony D, Rafter L, Reynolds T, Aljezawi M. An evaluation of serum albumin and the sub-scores of the Waterlow score in pressure ulcer risk assessment. J Tissue Viability. 2011;20(3):89-99. doi:10.1016/j.jtv.2011.04.001 CR - Akan C, Sayın Y. Prevalence of pressure injuries and risk factors in long-term surgical procedures. Bezmialem Sci. 2021;9(1):75-83. DOI: 10.14235/bas.galenos.2020.3820 CR - Hatanaka N, Yamamoto Y, Ichihara K, et al. A new predictive indicator for development of pressure ulcers in bedridden patients based on common laboratory tests results. J Clin Pathol. 2008;61(4):514-518. doi:10.1136/jcp.2007.050195 CR - Jacq G, Valera S, Muller G, et al. Prevalence of pressure injuries among critically ill patients and factors associated with their occurrence in the intensive care unit: The Pressure study. Aust Crit Care. 2021;34(5):411-418. doi:10.1016/j.aucc.2020.12.001 CR - Agarwal A, Basmaji J, Muttalib F, et al. High-flow nasal cannula for acute hypoxemic respiratory failure in patients with COVID-19: Systematic reviews of effectiveness and its risks of aerosolization, dispersion, and infection transmission. Can J Anaesth. 2020;67(9):1217-1248. doi:10.1007/s12630-020-01740-2 CR - Ogawa K, Asano K, Ikeda J, Fujii T. Non-invasive oxygenation strategies for respiratory failure with COVID-19: A concise narrative review of literature in pre- and mid-COVID-19 era. Anaesth Crit Care Pain Med. 2021;40(4):100897. doi:10.1016/j.accpm.2021.100897 CR - Gattinoni L, Coppola S, Cressoni M, et al. COVID-19 does not lead to a "typical" acute respiratory distress syndrome. Am J Respir Crit Care Med. 2020;201(10):1299-1300. doi:10.1164/rccm.202003-0817LE CR - González-Méndez MI, Lima-Serrano M, Martín-Castaño C, et al. Incidence and risk factors associated with the development of pressure ulcers in an intensive care unit. J Clin Nurs. 2018;27(5-6):1028-1037. doi:10.1111/jocn.14091 CR - Challoner T, Vesel T, Dosanjh A, Kok K. The risk of pressure ulcers in a proned COVID population. Surgeon. 2022;20(4):e144-e148. doi:10.1016/j.surge.2021.07.001 CR - Melo CMD, Bueno ADLG, Rossetto TL, et al. Pressure injury in intensive care unit: Prevalence and associated factors in patients with COVID-19. Rev Gaúcha Enferm. 2023;44:e20210345. UR - https://doi.org/10.26453/otjhs.1664017 L1 - https://dergipark.org.tr/tr/download/article-file/4718237 ER -