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

IDEA OF COLLECTIVE GARDENING AND ITS MATERIALISATION IN LITHUANIA / KOLEKTYVINIO SODO IDĖJA IR JOS MATERIALIZACIJA LIETUVOJE

The idea of a collective garden and its effect to Lithuanian built environment is described in the article. Collective gardens in Soviet times became an area to compensate the suppressed need for private property and also it was the place for informal, even corrupt practices. After the shift towards new political system collective gardens are facing intense transformation and it continues to be the “grey zone” where informal practices flourish. The presumption made in the article is that the appearance of collective gardens in Lithuania was heavily influenced by the cultural and economic reality of the Soviet Union. These conditions were crucial for formation of specific living environment in which informal urbanism appears. Santrauka  Kolektyviniai sodai buvo terpė, kurioje jau sovietmečiu pasireiškė nuslopintas privačios nuosavybės poreikis. Pasikeitus politinei šalies santvarkai, pasikeitė miestų planavimo principai, tačiau kolektyviniai sodai išliko „pilkąja zona“ kurioje ir toliau reiškėsi netipiniai urbanizacijos procesai. Tekste keliama prielaida, kad šis reiškinys yra Sovietų Sąjungai būdingų kultūrinių, politinių ir socialinių procesų rezultatas, o šio eksperimento palikimas Lietuvoje suformavo specifinę gyvenamąją terpę, kurioje vyrauja neformalaus urbanizmo praktikos. Straipsnyje glaustai atskleidžiamos kolektyvinio sodo idėjos atsiradimo aplinkybės, šios idėjos santykis su realia projektavimo ir statybos praktika Lietuvoje, bei minėto proceso įtaka šių dienų gyvenamajai aplinkai. Reikšminiai žodžiai: kolektyviniai sodai, urbanistikos istorija, utopija, posovietinės miestų transformacijos, neformali ekonomika, neformalus urbanizmas, užmiesčio namas