Document Detail

Pressure ulcer predictors in ICU patients: nursing skin assessment versus objective parameters.
MedLine Citation:
PMID:  18947019     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate objective parameters and subjective nursing assessment as pressure ulcer risk factors for intensive care unit (ICU) patients, and compared them with the performance of a general assessment tool (Waterlow scale). To validate the newly developed assessment method. METHOD: This prospective epidemiological study involved 698 patients admitted to an ICU between April 2001 and December 2004 without pressure ulcers and who stayed in the ICU for more than 72 hours. Objective parameters routinely determined during the first 24 hours in the ICU as well as subjective nursing assessment on admission were analysed for their significance as pressure ulcer risk predictors. RESULTS: Of the 698 patients 121 (17%) developed pressure ulcers in the ICU. With univariate analysis, a variety of objectively measurable parameters relating to organ dysfunction, circulatory impairment and sepsis showed significant association with the occurrence of pressure ulcers. When multiple logistic regression was performed, subjective nursing skin assessment parameters outweighed these parameters as pressure ulcer risk predictors. A risk function comprised of five skin-related and one other parameter yielded an overall correct pressure ulcer prediction proportion of 84.6%. With receiver-operator characteristic curve analysis, the area under the curve (AUC) was 0.82. Results were validated in 329 patients treated in the same ICU between January 2005 and May 2006, yielding an AUC of 0.80. CONCLUSION: Nursing skin assessment is an important pressure ulcer risk stratification tool in the ICU despite the availability of a large number of objectively measureable ICU specific parameters in these patients.
F Compton; F Hoffmann; T Hortig; M Strauss; J Frey; W Zidek; J H Schäfer
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of wound care     Volume:  17     ISSN:  0969-0700     ISO Abbreviation:  J Wound Care     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-24     Completed Date:  2009-02-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9417080     Medline TA:  J Wound Care     Country:  England    
Other Details:
Languages:  eng     Pagination:  417-20, 422-4     Citation Subset:  N    
Department of Nephrology, Charité University Medicine, Berlin, Germany.
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MeSH Terms
Intensive Care Units
Logistic Models
Middle Aged
Nursing Assessment*
Pressure Ulcer / epidemiology*,  physiopathology
Prospective Studies
Erratum In:
J Wound Care. 2008 Nov;17(11):493

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