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

Les rejets miniers de traitement : caractérisation, capacité polluante et impacts environnementaux, mine Zeïda, mine Mibladen, Haute Moulouya (Maroc)

The aim of this study is to characterize the wastes of treatment abandoned at the mine sites Zeida and Mibladen (Upper Moulouya, eastern of Morocco).highlight the polluting capacity of these wastes and determine their environmental impacts taking into account climate semi-arid and geological context carbonate and silicate in the region. The results showed that the mining wastes at Zeida (RZ) and at Mibladen (RM) consist of fine particle size, have low geotechnical stability, highly mobile and exhibit high levels of toxic trace metals (MTE) (Pb: 5547ppm for RZ//10520ppm for RM). These wastes with alkaline pH are affected by intense water erosion and in particular wind erosion and they create multiple environmental impacts. lndeed, in addition to the negative impact on the landscape that they generate, MTE contained in these wastes are transported, spread and contaminate surface water resources and soil around: (water: Pb: 13-430g/1//Sediments Pb:33-2415ppm //Soils: Pb:71-566 ppm). However, we note that the risk of contamination related to chemical weathering from the studied wastes is reduced sequel on the one hand to the Jack of moisture in semi-arid climate favoring chemical reactions within the waste and second/y due to the abundance of carbonates and 1 or silicates in wastes and into the geological terrain of the region. Phenomena of acid mine drainage (AMD), in particular acidification of surface water and leachate, most remarkable phenomenon of AMD were detected anywhere in mining districts. This is the contaminated neutral drainage (CND) for mining wastes of Zeïda and Mibladen at upper Moulouya. Mechanical wind erosion is the main vector of the dispersion of suspended particles of contaminants from wastes studied.L'objectif de cette étude est de caractériser les rejets miniers de traitement abandonnés aux centres miniers Zeïda et Mibladen (Haute Moulouya, oriental du Maroc), de mettre en exergue la capacité polluante de ces rejets et déterminer leurs impacts environnementaux tenant compte du climat semi-aride et du contexte géologique dans la région. Les résultats ont révélé que les verses à rejets miniers à Zeïda (RZ) et à Mibladen (RM) sont constituées de particules de taille fine, de stabilité géotechnique faible, très mobiles et présentent des teneurs élevées en éléments traces métalliques toxiques (ETM) (Pb : 5547ppm pour RZ//10520ppm pour RM).Ces rejets à pH alcalin (8,4) subissent l'effet d'une intense érosion hydrique et en particulier éolienne et créent de multiples impacts environnementaux. En effet, en plus de l'impact paysager négatif qu'ils génèrent, les ETM contenus dans ces rejets sont transportés, disséminés et contaminent les ressources en eaux de surface et les sols aux alentours : (Eaux : Pb : 13-430µg/l//Sédiments : Pb : 33-2415ppm//Sols : Pb : 71-566 ppm). Toutefois, on note que le risque de contamination lié à l'altération chimique à partir des rejets miniers étudiés est réduit suite d'une part au manque d'humidité en climat semi aride favorisant les réactions chimiques au sein des rejets et d'autre part suite à l'abondance des carbonates et/ou des silicates dans les rejets et dans les terrains géologiques de la région. Les phénomènes du drainage minier acide (DMA), en particulier l'acidification des eaux de surface et des lixiviats, phénomène le plus remarquable du DMA n'ont été décelés nulle part au niveau des districts miniers. Il s'agit du drainage neutre contaminé (DNC) pour les rejets des mines Zeïda et Mibladen de la Haute Moulouya. L'érosion mécanique éolienne est le vecteur principal de la dispersion, à partir des rejets miniers étudiés, de particules en suspension contaminants

Contamination des sols par les métaux lourds à partir de mines abandonnées : le cas des mines Aouli-Mibladen-Zeïda au Maroc

Cette étude évalue la contamination métallique des sols au voisinage des mines Aouli, Mibladen et Zeïda abandonnées dans la Haute Moulouya à l’est du Maroc, et s’attache en particulier à l’estimation de la variabilité spatiale de cette contamination et de l’étendue de l’aire contaminée. Les résultats révèlent que les sols proches des sites miniers étudiés et même très éloignés sont fortement contaminés par les métaux lourds – plomb (Pb), zinc (Zn), cuivre (Cu) et cadmium (Cd) ; ils soulignent également une grande variabilité des concentrations non seulement entre les trois sites miniers mais aussi dans un même site minier. L’index de pollution des sols étudiés est généralement élevé même pour les sols échantillonnés en aval à plus de 130 km des sites miniers, alors qu’il est extrêmement élevé en surface des verses de résidus miniers soulignant que ces dernières constituent en l’état des sources pérennes de contamination par les métaux lourds. L’aire insalubre touchée par la pollution métallique issue des sites miniers abandonnés dans la Haute Moulouya est très vaste suite à la dispersion, par les transports éoliens et hydriques, des polluants résiduels des rejets miniers abandonnés sur place. Des mesures de remédiation doivent être prises afin d’immobiliser les polluants et limiter leur transport vers l’environnement