A prospective, descriptive study of risk factors related to pressure ulcer development among patients in intensive care units.

Many risk factors for the development of pressure ulcers (PUs) in the general hospital population have been identified, but consensus is lacking on specific PU risk factors for critical care patients. A prospective, descriptive study was conducted to determine the incidence of and risk factors for PU development among high-risk patients (Braden risk scale score <12) admitted to an intensive care unit (ICU) of a university hospital in Turkey. Demographic variables, APACHE II scores, serum albumin, hemoglobin, and glucose levels were obtained, and patients' skin was assessed daily until discharge. Data were analyzed using percentage distributions, Student's t-test, chi-square, and logistic regression analysis. Seventy (70) patients (22 women, 48 men), average age 56.2 (SD 19.2) years, mean albumin level 2.86 (median: 2.86, SD 2.73), and mean APACHE II score 17.2 (SD 6.48), completed the study. During an average length of stay of 17.2 days (SD 4.2), PU incidence was 28.6%. Of the 23 ulcers that developed, 12 (52.1%) were Stage I, eight (8, 34.8%) were Stage II, and three (3, 13.1%) were Stage III; no patient developed a Stage IV ulcer. Multivariate logistic regression analysis showed that being female (OR = 0.15, [95% CI:0.03- 0.71] P <0.05) and having a lower serum albumin level (OR=11.6, [95% CI:1.92- 70.4] P <0.01) were independent risk factors for PU development. Patient gender and serum albumin levels should be considered as risk factors for PU development in ICU patients. Larger prospective studies examining these risk factors in ICU patients are warranted.