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

A determinant for family planning attitudes and practices of men: marriage features

Aim: This study was conducted to determine both the use of family planning methods among married men between the ages of 20 to 50 and some marriage characteristics affecting this use. Methods: This was a descriptive and correlational study conducted in May and June 2014. The study sample included 375 males. The study data were collected using a survey form as well as the Family Planning Attitude Scale, Marital Adjustment Scale, and Marital Problem Solving Scale. The determinants of the Family Planning Attitude Scale were found using hierarchical multiple regression analysis. The risk factors for not using family planning were evaluated by logistic regression analysis. Results: According to Model 2, to which family features were added, the male himself (ß = -0.117) and his spouse (ß = -0.154) either graduated from primary school or received no formal education. They lived in an extended family (ß = -0.129), and an increasing desire for more children (ß = -0.184) decreased the family planning attitude score. The risk factors for not using family planning were evaluated using logistic regression analysis. Accordingly, the risk for not consulting family planning services is increased by older age (OR: 1.037; CI: 1.010–1.064), desiring to have more than three children (OR: 1.279; CI: 1.01.038–1.575), and not having received information about family planning (OR: 1.871; CI: 1.145–3.057) (p < 0.05). Conclusion: Marital adjustment is an important tool in making decisions about family planning. It is necessary to enable men to access to the correct information that will carry them to the relevant resources. © 2018, Springer-Verlag GmbH Germany, part of Springer Nature

Bilateral pneumothoraces in a patient with laryngeal carcinoma following tracheostomy for stridor.

A pneumothorax following a tracheostomy is a known but rare complication. Bilateral pneumothoraces are rarer still and very few are described in the literature. We present a case of bilateral pneumothoraces following an emergency tracheostomy in a female patient with known laryngeal carcinoma. She was managed with bilateral intercostal chest drains (ICDs) with good result. Anatomical integrity of the oesophagus was confirmed using barium swallow. Prior to removal of the drains a CT scan of the thorax was performed that showed disease progression and led to a change in the initial curative plan. We emphasise the importance in early diagnosis of this complication with a low index of suspicion. We suggest regular monitoring and a low threshold for treatment with bilateral ICDs

Effectiveness of air purifiers in intensive care units: an intervention study

Background: Effective design and operation of intensive care unit (ICU) ventilation systems is important to prevent hospital-acquired infections. Air purifiers may contribute