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

REVIEW AND DEVELOPMENT OF ENVIRONMENTAL IMPACT STATEMENTS IN KUWAIT: A STEP TOWARDS MITIGATION OF ENVIRONMENTAL CRISIS ASSOCIATED WITH MAJOR PROJECTS

Major development projects, within the third review of the Kuwait Master Plan (KMP3), are proposed for the period (2005–2030). These projects include, among other things, the construction of new towns, industrial areas, power plants, highways, hospitals, waterfront projects and sanitary projects. All of these projects are well known to have adverse environmental impacts unless necessary precautions are taken in their planning stages. As per Article 8 of Law 21 of 1995 and its amendments, the proponents of such projects are requested to submit a comprehensive Environmental Impact Statement (EIS) document for review before an environmental permit is given by the Environment Public Authority (EPA) in Kuwait. There is at present inadequate information available to help the proponents in this task, and the aim of this paper, is to provide a set of preliminary guidelines for the review and development of EIS documents for various types of major development projects. Although the examples focus on Kuwait, the principles discussed are generally applicable. The future challenges to enhance the review and development process are also discussed.Environmental Impact Assessment (EIA), Environmental Impact Statement (EIS), EIS review, development projects, Kuwait master plan

Greenhouse gas (GHG) emissions in the Sultanate of Oman

Worldwide, many countries are being affected by greenhouse gas (GHG) emissions. The Sultanate of Oman is no exception. In Oman, both oil- and natural-gas-related activities have the most important shares of the nation's Gross Domestic Product (GDP). Hence, they are expected to be the primary cause of GHG emissions within the country. In this study, the greenhouse carbon dioxide emissions (CO2) released from the fossil fuels (i.e., oil and natural gas) used in the country for energy production purposes was computed by using the Intergovernmental Panel on Climate Change (IPCC) reference approach for National Greenhouse Gas Inventories. The objective was to develop the CO2 emissions for Oman over the last 40 years starting from year 1972. The obtained results indicated that Oman has a growth in its CO2 GHG emissions. This study is very important and essential, as it will assist Oman to monitor its progress in reducing CO2 emissions

Particulate air pollution at schools: indoor-outdoor relationship and determinants of indoor concentrations

This study aimed to assess the relationship between indoor and outdoor particulate air pollution at primary schools, and identify the determinants of indoor pollution concentrations. The study was conducted in six classrooms within six primary schools in Sari, Northern Iran. Indoor concentrations of particulate matter (PM) with an aerodynamic diameter of less than 10 µm (PM10), 2.5 µm (PM2.5), and 1 µm (PM1.0) were assessed in classrooms, and outdoor concentrations of PM2.5 on the school playgrounds were monitored simultaneously by using two real-time and portable dust monitors during autumn, winter, and spring, yielding 26 sampling days for each school in total. The highest outdoor and indoor PM2.5 concentrations were found in winter and spring, respectively. The mean indoor PM2.5 concentration (46.9 ± 32.9 µg m–3) was higher than that measured outdoors (36.8 ± 33.2 µg m–3). Indoor PM2.5 and PM1.0 were moderately correlated with outdoor PM2.5 concentrations, which was the main determinant for all indoor particulate concentrations, however, a distinct pattern was observed for PM10 and PM2.5 compared to PM1.0. While meteorological variables (i.e., ambient temperature, relative humidity) could predict indoor PM10 and PM2.5 concentrations, the total area of the windows and the number of students in a classroom were predictors for PM1.0 levels. The findings of this study could inform policymakers in implementing evidence-based targeted interventions aimed at reducing air pollution in school settings