| Objective:The clinical data of elderly patients with pressure injury on admission were analyzed retrospectively to provide baseline data for strengthening the management of this special disease group.Logistic regression analysis was used to study the influencing factors of outcomes of elderly patients with pressure injury in order to provide evidence for clinical prevention and treatment of pressure injury in the elderly.Methods:A self－designed“Data Collection Table for Hospitalized EIderiy Patients with Pressure Injury was used to collect retrospectively the elderly pressure treated in the Department of Bum surgery,First Hospital of Jilin University,from 2016.12-2018.12.with pressure injury as the primary diagnosis.The demographic data of the variables included:sex,age(year),residence status;The disease data on admission included:blood pressure(mnrmHg),temperature(’C),diabetes mellitus,cardiovascular disease,sensory dysfunction,motor dysfunction,consciousness disorder;Wound data include:wound site,wound area(cm2),clinical stage;Adjunct examination data on admission:total protein(g/L)t albumin(g/L).erythrocyte count(1012/L),lymphocyte absolute value(109/L),hemoglobin(g/L),cholinesterase(U/L);Time data included:time from onset to admission(months);Treatment data pre-hospital including:wound repair methodsr combined use of NPWT;Nursing data pre-hospital including:whether or not there is an intensive care unit experience,Self-care situation and whether to apply pressure-reducing equipment;Other relevant parameters include:the hospitalization time(days)and the treatment cost of the hospitalization(ten thousand Yuan).1.Descriptive analysis was made on the demographic data,the disease data on admission,wound data,adjunct examination data on admission,time data,treatment data included pre-hospital,nursing data pre-hospital,other relevant parameters.2.After scientific systematic treatment,the patients were divided into survival group and death group according to clinical outcome.Single factor analysis was made for seven related data including demographic data,disease data,wound data,auxiliary examination data,time factors,pre-hospital treatment data and pre-hospital nursing data.3.According to the positive results of univariate analysis,combined with clinical experience,the confounding factors were excluded and included in the Logistic regression equation.After variable assignment,single factor positive variable was used as independent variable of multivariate Logistic regression analysis,and regression analysis was carried out with dependent variable.Statistical methods:SPSS 23.0 software was used to process the data.The counting data were expressed as percentage,chi-square(X 2)or Fisher test was used,the measurement data were expressed by X±S,and the T test was used.P<0.05,the difference was statistically significant.Results:Among the 98 elderly patients with pressure injury,the age ranged from 65 to 97 years with a mean age of(78.38±13.11)years.There were 50 males(51.02%)and 48 females(48.98%).Among the subjects,the 65-75-year-old group had the highest proportion,accounting for 44.8%of the total.Most of the patients in the group were urban residents(92.86%)and rural residents only 7.14%.The highest percentage of ischium nodules was found in 73 cases(41.08%),and the lowest was in scapula and foot(0.56%).The clinical stages were mainly 3 stages(n=112[62.92%]).The proportion of patients with cardiovascular disease on admission was 35.71%,the proportion of patients with diabetes mellitus was 20.41%,the proportion of patients with sensory dysfunction was 43.88%,and the proportion of patients with motor dysfunction was 56.12%.The proportion of patients with consciousness disorder was 48.98%.The time from onset to admission was(7.5±1.2)months.The average hospitalization days were(34.0±14.0)days.The average costs of treatment was(4.4±0.7)thousand yuan.According to the results of systematic treatment,98 elderly patients were divided into two groups:cured group and unhealed group,83 cases were completely cured and 15 cases were not cured.The results of single factor group comparison were as follows:there was significant difference in age and residence attribute in demographic data(all P<0.001).There were significant differences in cardiovascular disease,diabetes mellitus,sensory dysfunction,motor dysfunction and consciousness disorder(P=0.007,P<0.001,P<0.001,P=0.043,P=0.003 respectively).There was significant difference in blood pressure between groups(P=0.023,P=0.029).There were significant differences in albumin,lymphocyte absolute value,hemoglobin and cholinesterase(P<0.001,P<0.02,P<0.05,P<0.001,respectively).There were significant differences in wound site,area and clinical staging(P<0.001,P<0.021,P<0.001,respectively).In the treatment of pre-hospital wound,the combined use of negative pressure suction had significant difference(P=0.011,P<0.001).The data of single factor group showed that there was significant difference(P<0,001)in the time between the onset of the disease and the time of seeing a doctor(P<0.05).In the data of pre-hospital nursing,there was a significant difference in the hospitalization experience of ICU and the self-care status among the groups(P<0.032,P<0.012).Independent variables were selected as independent variables,and dependent variables were taken as dependent variables,which were especially significant in inter-group univariate analysis.In the regression equation,Logistic multivariate analysis showed that age,repair methods,wound location,albumin and the time from onset to admission were highly correlated with the outcome of stress injury in the elderly.Conclusion:1.The occurrence and development of elderly patients with pressure injury may be related to several factors,including age,residence,cardiovascular diseases,diabetes,sensory dysfunction,albumin,lymphocyte absolute value,hemoglobin,cholinesterase,clinical stage,combined use of NPWT,repair methods,onset to hospital time and self-care.2.The risk factors affecting the outcomes of elderly patients with pressure injury may include age,repair methods,wound location,albumin and the time from onset to admission. |
