Study On The Incidence And Risk Factors Of Unavoidable Pressure Ulcers In Hospital Patients

Objective: The aim of this study is to analyze the risk factors of unavoidable pressure ulcer and the epidemiological characteristics of hospital patients in a general hospital in 2015,which will contribute to the evaluation,the declaration and the prevetion of indomethacin.Method: A retrospective study method was conducted in the current study to collect data in the patients with high risk of unavoidable pressure ulcers in the First Affiliated Hospital of Fourth Military Medical University from January to December of 2015.After performing the include and outclude criteria of this study,patients were required to finish the "hospitalized patients with unavoidable pressure ulcer related factors questionnaire".The data was imputed with the Epidata 3.1 software and was analyzed by the SPSS19.0.The risk factors of UPU in non-surgical patients and surgical patients were analyzed by the logistic regression.The prevalence and ategorical variables of UPU was expressed as percentage and analyzed by c2 test,t test,nonparametric rank sum test.The test level(α)was 0.05,all P <0.05 was considered as statistically significant.Result: 1.Epidemiological characteristics: A total of 1446 cases was include in this study.The male was 933(63.1%)and female was 533(36.9%),the ratio of sex was 1.71: 1.The average age was 56.25 ± 19.59,the main catergory year groups is 60 group(47.58%),the highest proportion of education is junior high school(33.2%).Time distribution characteristics: UPU more occurred in the summer than other seasons,the August accounted for10.58% and the June accounted for 10.53% and July accounted for 10.09% while the February accounted for3.03%.The stage of UPU: all 103 patients suffer from UPU.The pressure ulcer number is 139,56.1% in stageⅠ,30.2% in stage Ⅱ,1.4% in stage Ⅲ and 12.2% ulcers may be suspicious deep tissue injury.Most UPU was detect in the sacrococcygeal(35.3%)and hip(13.7%).The incidence of UPU in head and neck(nose,ear,lips,jaw)was 18.7% and most in nose(5%).UPU occurred in the different departments: The incidence of UPU in the whole hospital is 7.12%,most in the operation room(15.07%),the second is ordinary ward(7.17%),less in ICU(4.65%).In the department of operation rooms,more UPU was detected in orthopedics(33.93%).The highest incidence of UPU was found in surgery intensive care(30.77%)among ICUs.In the departments of general wards,the most UPU patients were found in the Neurosurgery(22.22%).If the data was catergoried with diseases,the orthopedics showed the highest prevalence of UPU(16.67%).2.Risk factors for UPU: There were 41 cases(39.81% of all cases)of operation patients(18.81% of all patients)suffers from UPU but only 5.28%(62 cases of 1174 patients)non-surgery patients suffers from UPU.Which means patients with operation is more volunerable to the UPU.All 15 risk factor of UPU was detected in non-surgry patients: muscle strength,cardiac function,consciousness,skin type,incontinence,pain,the severity of the diseas,rescue or not,mechanical ventilation,albumin level,blood glucose level,count of RBC,potassium level,blood pressure,body temperature.Multivariate logistic analysis showed that the consciousness(OR=3.63,95% CI:1.08 ~ 12.21),the severity of disease(OR=5.09,95% CI:2.87 ~ 9.04),rescue(OR=5.74,95% CI:2.73 ~ 12.07),albumin(OR=3.68,95% CI:1.30~10.37),high blood glucose level(OR=3.92,95%CI:2.25~6.86),pain(OR=4.08,95% CI:1.25~13.36)were the major risk factors for UPU of non-surgery patients.There were 9 risk factors of UPU for the patients with operation: count of WBC,blood pressure,body temperature,Sp O2,duration of operation,perioperative blood loss,body mass index,intraoperative external pressure,and operation position.Multivariate logistic analysis showed low temperature(OR=9.78,95% CI:4.62~20.69),duration of operation(OR=3.87,95% CI:1.03~14.51),the amount of bleeding(OR=12.06,95% CI:3.38~43.06)was the major risk factor for UPU in surgical patients.Conclusion: UPU is more likely to occur in the summer than in other seasons.The highest prevalence of UPU was detected in operation room.For non-surgery patients,the risk factor was strength,consciousness,the severity of disease,albumin and blood glucose.For surgery patients,worse preoperative psychological status,duration of surgery,the amount of bleeding are the risk factors.