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

HEALPix: A Framework for High-Resolution Discretization and Fast Analysis of Data Distributed on the Sphere

HEALPix the Hierarchical Equal Area isoLatitude Pixelization is a versatile structure for the pixelization of data on the sphere. An associated library of computational algorithms and visualization software supports fast scientific applications executable directly on discretized spherical maps generated from very large volumes of astronomical data. Originally developed to address the data processing and analysis needs of the present generation of cosmic microwave background experiments (e.g., BOOMERANG, WMAP), HEALPix can be expanded to meet many of the profound challenges that will arise in confrontation with the observational output of future missions and experiments, including, e.g., Planck, Herschel, SAFIR, and the Beyond Einstein inflation probe. In this paper we consider the requirements and implementation constraints on a framework that simultaneously enables an efficient discretization with associated hierarchical indexation and fast analysis/synthesis of functions defined on the sphere. We demonstrate how these are explicitly satisfied by HEALPix

Calibration and Characterization of the Radiation Assessment Detector (RAD) on Curiosity

The Radiation Assessment Detector, RAD, is one of the ten instruments that make up the science payload of the Mars Science Laboratory Curiosity rover. RAD is an energetic particle detector, capable of measuring the charged and neutral particles that make significant contributions to the radiation dose that will be received by future human explorers when they visit Mars. Prior to the launch of MSL in November 2011, RAD and its nearidentical twin flight spare unit were calibrated using laboratory sources, charged particle beams, and neutron fields. The initial calibration parameters obtained in these tests were used for real-time data analysis by the instrument’s onboard software. These parameters have subsequently been refined using data obtained during the cruise to Mars and during Curiosity’s mission on the surface of Mars. The most critical use of alibration is in the dosimetry analysis performed onboard. Calibration is also used in onboard analysis to determine which events should be stored for telemetry to Earth. Accelerator data obtained with the flight spare unit after Curiosity was launched provide detailed information about the response of the organic and inorganic scintillators to ion beams over a wide range of chargeand energy. Here we report on the methods used to determine calibration parameters, the results obtained, as well as providing an overview of the modifications to the instrument’s software and configuration that have been made over the course of the mission