Hospital‐acquired pressure ulcers and risk of hospital mortality in intensive care patients on mechanical ventilation

Abstract

Abstract Rationale, aims and objectives Pressure ulcers ( PUs ) are a common and serious complication in critically ill patients. The aim of this study was to evaluate the relationship between the development of a PU and hospital mortality in patients requiring mechanical ventilation ( MV ) in an intensive care unit ( ICU ). Methods A prospective cohort study was performed over two years in patients requiring MV for ≥ 24 hours in a medical‐surgical ICU . Primary outcome measure was hospital mortality and main independent variable was the development of a PU grade ≥ II . Hazard ratios ( HRs ) were calculated using a C ox model with time‐dependent covariates. Results Out of 563 patients in the study, 110 (19.5%) developed a PU . Overall hospital mortality was 48.7%. In the adjusted multivariate model, PU onset was a significant independent predictor of mortality (adjusted HR , 1.28; 95% confidence interval, 1.003–1.65; P = 0.047). The model also included the A cute P hysiology and C hronic H ealth E valuation II score, total S equential O rgan F ailure A ssessment on day 3, hepatic cirrhosis and medical admission. Conclusion Within the limitations of a single‐centre approach, PU development appears to be associated with an increase in mortality among patients requiring MV for 24 hours or longer.