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

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

Phrenological controversy and the medical imagination: 'a modern Pythagorean' in Blackwood's Edinburgh Magazine

No abstract available

Chapter 8 Phrenological Controversy and the Medical Imagination: 'A Modern Pythagorean' in Blackwood's Edinburgh Magazine

Scottish Medicine and Literary Culture, 1726–1832 examines the ramifications of Scottish medicine for literary culture within Scotland, throughout Britain, and across the transatlantic world. The contributors take an informed historicist approach in examining the cultural, geographical, political, and other circumstances enabling the dissemination of distinctively Scottish medico-literary discourses. In tracing the international influence of Scottish medical ideas upon literary practice they ask critical questions concerning medical ethics, the limits of sympathy and the role of belles lettres in professional self-fashioning, and the development of medico-literary genres such as the medical short story, physician autobiography and medical biography. Some consider the role of medical ideas and culture in the careers, creative practice and reception of such canonical writers as Mark Akenside, Robert Burns, Robert Fergusson, Sir Walter Scott and William Wordsworth. By providing an important range of current scholarship, these essays represent an expansion and greater penetration of critical vision

Scottish Medicine and Literary Culture, 1726-1832

Scottish Medicine and Literary Culture, 1726–1832 examines the ramifications of Scottish medicine for literary culture within Scotland, throughout Britain, and across the transatlantic world. The contributors take an informed historicist approach in examining the cultural, geographical, political, and other circumstances enabling the dissemination of distinctively Scottish medico-literary discourses. In tracing the international influence of Scottish medical ideas upon literary practice they ask critical questions concerning medical ethics, the limits of sympathy and the role of belles lettres in professional self-fashioning, and the development of medico-literary genres such as the medical short story, physician autobiography and medical biography. Some consider the role of medical ideas and culture in the careers, creative practice and reception of such canonical writers as Mark Akenside, Robert Burns, Robert Fergusson, Sir Walter Scott and William Wordsworth. By providing an important range of current scholarship, these essays represent an expansion and greater penetration of critical vision

Chapter 8 Phrenological Controversy and the Medical Imagination: 'A Modern Pythagorean' in Blackwood's Edinburgh Magazine

Scottish Medicine and Literary Culture, 1726–1832 examines the ramifications of Scottish medicine for literary culture within Scotland, throughout Britain, and across the transatlantic world. The contributors take an informed historicist approach in examining the cultural, geographical, political, and other circumstances enabling the dissemination of distinctively Scottish medico-literary discourses. In tracing the international influence of Scottish medical ideas upon literary practice they ask critical questions concerning medical ethics, the limits of sympathy and the role of belles lettres in professional self-fashioning, and the development of medico-literary genres such as the medical short story, physician autobiography and medical biography. Some consider the role of medical ideas and culture in the careers, creative practice and reception of such canonical writers as Mark Akenside, Robert Burns, Robert Fergusson, Sir Walter Scott and William Wordsworth. By providing an important range of current scholarship, these essays represent an expansion and greater penetration of critical vision

Killing two birds with new homes How developing car parks could provide much needed new housing and reduce traffic

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