Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Reliability analysis of gas pipelines under global bending and thermal loadings considering a high chloride ion environment

The long-distance gas pipelines inevitably experience global bending deformation due to the ground movements. Meanwhile, a harsh environment where both the temperature may change drastically and the high chloride ion soil condition possibly causes more severe corrosion on the pipelines, could pose a significant challenge to pipeline safety. It is very crucial to ensure gas pipeline safety and durability in the energy transportation industry. Therefore, this study aims to systematically investigate the failure pressure of corroded gas pipelines under the combined effects of global bending and temperature difference. Considering gas pipelines potentially exposed to soil conditions with different contents of sodium chloride (NaCl), five corrosion rate models were for the first time employed to carry out reliability-based lifetime prediction analysis. The results show that compared to the case without global bending and temperature difference, the service life of gas pipelines can be reduced by 14 % in the case of global bending strain of 0.25 % and temperature difference of −40 °C. As for the corrosion rate model, the Model 4 plays a strongly adverse role in the service life of gas pipelines. Furthermore, parametric sensitivity analysis indicates that apart from the working pressure, initial corrosion depth and the radial corrosion rate are the two more influential factors in affecting the service life of gas pipelines.This work was financially supported by the Scientific and Technological Research Program of Chongqing Municipal Education Commission (Grant No. KJCXZD2020002), Key Laboratory of New Technology for Construction of Cities in Mountain Area, Ministry of Education, Chongqing University (Grant No. LNTCCMA-20210111) and State Key Laboratory of Mechanics and Control for Aerospace Structures (Nanjing University of Aeronautics and astronautics) (Grant No. MCMS-E-0123G02)

Assessing the Impact of Different Agricultural Irrigation Charging Methods on Sustainable Agricultural Production

China is currently experiencing severe water scarcity issues in its agricultural production sector. To address this challenge, the Chinese government has taken steps towards implementing a nationwide reform in agricultural water pricing to accelerate the more sustainable management of the agricultural water resources sector. The present study adopted a multiple regression model to test four alternative irrigation water charging methodologies (charges based on ladder pricing, time, land area, and electricity) accompanied by supportive agricultural pricing policies to address the inherent conflicts between water conservation and agricultural development goals. This study focused on the Wei River Basin, which is recognized as a highly water-stressed region in China. This basin was chosen as a pilot area for comprehensive reform initiatives related to agricultural water pricing and served as the geographical scope for our research. Between June and July of 2022, we conducted comprehensive field surveys within the Wei River Basin, accumulating a dataset of 415 data points pertaining to the crop year of 2022. Our results showed that the ladder water price-based method exhibited remarkable potential in achieving substantial savings, with a minimum of 60.5239 m3/mu of irrigation water conserved for food crops and an impressive 67.8090 m3/mu for cash crops. However, regarding water-saving irrigation technologies, the estimation results indicated that electricity-based charging outperformed the other methods, resulting in an impressive 55.22% increase when ladder pricing served as the benchmark. In addition, regarding agricultural green production, the results for food crops and cash crops are different, with food crops being more sensitive to the ladder water price policies. Moreover, the results suggested that different water charging methods have significant heterogeneity effects from the perspective of the farmers’ scale, land fragmentation, and water price awareness capacity. This study forges an innovative path for water-stressed nations to execute agricultural water pricing reform and enhance agricultural production’s sustainable growth