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

Descripción Histológica del Hígado de Hydrochoerus hydrochaeris, Linnaeus, 1766

El objetivo de este estudio fue describir la histología del hígado del chigüire (Hydrochoerus hydrochaeris). Para tal fin, se utilizaron 13 hígados de individuos adultos de ambos sexos, con un peso entre 33 y 50 kg de peso, los cuales fueron sacrificados en el Matadero- frigorífico de Pro-Fauna, localizado en el municipio de Iguape, estado de São Paulo y en el campus de la Universidad Federal de Viçosa, en el estado de minas Gerais, Brasil. Las muestras fueron fijadas en líquido de Bouin y en solución de formol al 10% v/v, y se procedió a realizar el procesamiento histológico de rutina. Para la visualización diferencial del tejido conjuntivo y de las fibras colágenas para la descripción general del tejido, se realizaron cortes de tejido de 4 μm, los cuales fueron coloreados posteriormente parasu estudio histológico, utilizando las técnicas de coloración de hematoxilina & eosina, P.A.S. y Tricrómico de Gomori. Los resultados del estudio revelaron la presencia de un parénquima hepático y lobulillos, los cuales se encontraban próximos unosa otros, no existiendo delimitación marcada entre ellos. Los hepatocitos se encontraban agrupados en placas o hileras que se anastomosaban entre sí, y se disponían en una capa de células. Desde el punto de vista histológico, el parénquima hepático del Hydrochoerus hydrochaeris puede ser consideradocomo semejante en diversos aspectos, al de otrosmamíferos.AbstractThe objective of the present study was to histologically describe the liver of the capybara (Hydrochoerus hydrochaeris). For that purpose, 13 livers of capybaras of both sexes, weighing between 33 and 50 kg, were used. The animals were slaughtered in the Pro-Fauna refrigerated slaughterhouse, located in Iguape, the State of São Paulo and in the campus of the Universidad Federalde Viçosa, the State of Minas Gerais, Brasil. Samples were fixed in Bouin and formalin solution (10% v/v) and a routine histological processing was made. For the differential visualization of the connective tissue and colagen fibers, and for the general description of the tissue, sections of tissuesof 4 μm were made. Subsequently, tissue sections were stained with hematoxylin and eosin, P.A.S., and Gomori trichrome. The results of the study revealed the presence of a liver parenchyma and lobules, which were close to one another, without a marked delimitation among them. The hepatocytes were grouped in plates or rows which anastomosed with each other and were arranged in a layer of cells. From the histological standpoint, the liver parenchyma of the Hydrochoerus hydrochaeris canbe considered similar in various aspects, to that of other mammals

Caracterização microscópica das regiões esofágicas de um grupo de Capivaras (Hydrochoerus hydrochaeris) livres no Brasil

Morphological studies on wildlife animals have increased in an attempt to explore and understand minutely their adaptive evolution and how it relates to or differentiate from domestic animals. The aim of this study was to describe microscopically esophageal regions (cranial, middle and caudal) of a group of male and female capybaras, using histological techniques. Samples were harvested, fixed, processed and analyzed. All three esophageal regions were covered by keratinized stratified epithelium, thicker in folds apex and towards the caudal region, proximal to the stomach. In this layer, stratum granulosum was well developed. The submucosa, constituted of loose connective tissue, showed no glands. The muscular layer, externally lined by serous and/or adventitial layer, presented two orientations (circular and longitudinal) in the three regions, and it showed striated skeletal muscle fibers with developed nerve plexusOs estudos morfológicos em animais de fauna silvestre têm aumentado na tentativa de explorar e conhecer em detalhes suas adaptações, e como estas se relacionam ou diferenciam com as dos animais domésticos. O objetivo deste trabalho foi descrever microscopicamente as regiões esofágicas (cranial, média e caudal) de um grupo de capivaras de ambos os sexos, por meio de técnicas histológicas de coloração. As amostras foram previamente obtidas, fixadas, processadas e analisadas. Observou-se que as três regiões esofágicas estavam revestidas por epitélio estratificado pavimentoso queratinizado, sendo mais espesso, em geral, no ápice das pregas e sua espessura aumenta em direção à regi ão caudal, próximo ao estômago. Nesta camada, o estrato granuloso está bem desenvolvido. A submucosa de tecido conjuntivo frouxo é aglandular. A camada muscular revestida pela serosa e/ou adventícia externamente, apresentou duas orientações (circular e longitudinal) nas três regiões, e é constituída por fibras musculares estriadas esqueléticas com plexos nervosos desenvolvidos.Los estudios morfológicos en animales de fauna silvestre han aumentado en la tentativa de explorar y conocer en detalle sus adaptaciones, y como estas se relacionan o diferencian con las de los animales domésticos. El objetivo de este trabajo fue describir microscópicamente las regiones esofágicas (craneal, media y caudal) de un grupo de capibaras de ambos sexos por medio de técnicas histológicas de coloración. Las muestras fueron previamente obtenidas, fijadas, procesadas y analizadas. Se observó que las tres regiones esofágicas estaban revestidas de epitelio estratificado plano queratinizado, siendo más espeso, en general, en el ápice de los pliegues y su espesura aumenta en dirección a la región caudal, próxima al estómago. En esta camada, el estrato granuloso está bien desarrollado. La submucosa es de tejido conectivo laxo, es aglandular. La camada muscular revestida por la serosa y/o adventicia externamente, presentó dos orientaciones (circular y longitudinal) en las tres regiones, y es constituida de fibras musculares estriadas esqueléticas con plexos nerviosos desarrollados

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 (Intensive Care Medicine, (2021), 47, 2, (160-169), 10.1007/s00134-020-06234-9)

The original version of this article unfortunately contained a mistake. The members of the ESICM Trials Group Collaborators were not shown in the article but only in the ESM. The full list of collaborators is shown below. The original article has been corrected