Risk factors for heel pressure injury in cardiovascular intensive care unit patients

AbstractBackgroundPaediatric hospital-associated venous thromboembolism is a leading quality and safety concern at children’s hospitals.ObjectiveThe aim of this study was to determine risk factors for hospital-associated venous thromboembolism in critically ill children following cardiothoracic surgery or therapeutic cardiac catheterisation.MethodsWe conducted a retrospective, case–control study of children admitted to the cardiovascular intensive care unit at Johns Hopkins All Children’s Hospital (St. Petersburg, Florida, United States of America) from 2006 to 2013. Hospital-associated venous thromboembolism cases were identified based on ICD-9 discharge codes and validated using radiological record review. We randomly selected two contemporaneous cardiovascular intensive care unit controls without hospital-associated venous thromboembolism for each hospital-associated venous thromboembolism case, and limited the study population to patients who had undergone cardiothoracic surgery or therapeutic cardiac catheterisation. Odds ratios and 95% confidence intervals for associations between putative risk factors and hospital-associated venous thromboembolism were determined using univariate and multivariate logistic regression.ResultsAmong 2718 admissions to the cardiovascular intensive care unit during the study period, 65 met the criteria for hospital-associated venous thromboembolism (occurrence rate, 2%). Restriction to cases and controls having undergone the procedures of interest yielded a final study population of 57 hospital-associated venous thromboembolism cases and 76 controls. In a multiple logistic regression model, major infection (odds ratio=5.77, 95% confidence interval=1.06–31.4), age ⩽1 year (odds ratio=6.75, 95% confidence interval=1.13–160), and central venous catheterisation (odds ratio=7.36, 95% confidence interval=1.13–47.8) were found to be statistically significant independent risk factors for hospital-associated venous thromboembolism in these children. Patients with all three factors had a markedly increased post-test probability of having hospital-associated venous thromboembolism.ConclusionMajor infection, infancy, and central venous catheterisation are independent risk factors for hospital-associated venous thromboembolism in critically ill children following cardiothoracic surgery or cardiac catheter-based intervention, which, in combination, define a high-risk group for hospital-associated venous thromboembolism.

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Contribuição da equipe de enfermagem na prevenção de lesões por pressão em pacientes internados nas unidades de terapia intensiva (UTI)

Research Society and Development ◽

10.33448/rsd-v9i11.9468 ◽

2020 ◽

Vol 9 (11) ◽

pp. e329119468

Author(s):

Vera Lúcia da Silva Lima ◽

Alaine Maria da Costa ◽

Maria Esther Silva ◽

Irizete Maria da Silva ◽

Gabriela Oliveira Parentes da Costa ◽

...

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Intensive Care ◽

Preventive Measures ◽

Qualitative Approach ◽

Skin Integrity ◽

Pressure Injury ◽

Great Relevance ◽

Terapia Intensiva ◽

Critical Patients

Objective: The objective of this study was to analyze the scientific production about the contribution of nurses in the prevention of pressure injuries in patients admitted to the Intensive Care Unit. Method: This is a descriptive study, with a qualitative approach, of the integrative review type of health journals, indexed in the VHL, LILACS, MEDLINE and SCIELO databases, from 2010 to 2016, using the descriptors for consultation: Intensive care units; Nursing care; Pressure ulcer. Results and Discussion: Eight scientific articles were selected, whose prevalence addressed the identification of risk factors and preventive measures. 83.33% of the studies had a qualitative approach as the selected method. The nurse is seen as a leader in care management, providing critical patients with direct assistance, supervision, guidance and stimulation of the nursing team However, despite technological and scientific advances and the improvement of services and health care, the incidence of Pressure Injury remains high, especially in intensive care unit patients. Final Considerations: It was noticed that the nurse has great relevance in the implementation of protocols and in the execution of preventive measures. The results obtained refer the nurse as a leader capable of early identification of risk factors and of implementing preventive measures aimed at patient safety and reduction of damages involving skin integrity.

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Prevalence and Risk Factors for Postoperative Delirium in a Cardiovascular Intensive Care Unit

American Journal of Critical Care ◽

10.4037/ajcc2008.17.6.567 ◽

2008 ◽

Vol 17 (6) ◽

pp. 567-575 ◽

Cited By ~ 48

Author(s):

Yu-Ling Chang ◽

Yun-Fang Tsai ◽

Pyng-Jing Lin ◽

Min-Chi Chen ◽

Chia-Yih Liu

Keyword(s):

Risk Factors ◽

Intensive Care Unit ◽

Cardiac Surgery ◽

Intensive Care ◽

Postoperative Delirium ◽

Acute Infection ◽

Univariate Analysis ◽

Open Heart Surgery ◽

Chang Gung Memorial Hospital ◽

Cardiovascular Intensive Care

Background Delirium after cardiac surgery is a common complication in cardiovascular intensive care units. The prevalence of delirium and its likely risk factors have not previously been explored in a single sample of postoperative cardiac patients in an intensive care unit. Objective To compare a variety of characteristics in patients with and without delirium and to identify risk factors associated with delirium in patients hospitalized in an intensive care unit after cardiac surgery. Methods A retrospective chart review was used to collect data on 288 patients who had open heart surgery during the period 2004 to 2005 at Chang Gung Memorial Hospital in northern Taiwan. A researcher-designed checklist of 52 patient-related risk factors for delirium was used to collect preoperative, intra-operative, and postoperative data. All patients were assessed by psychiatrists, and delirium was diagnosed according to criteria of the Diagnostic and Statistical Manual of Mental Disorders, fourth edition. Data were analyzed via univariate analysis and multivariate logistic regression. Results The prevalence of postoperative delirium was 41.7%. Patients with and without delirium differed significantly on 29 variables. Four postoperative factors, hematocrit less than 30%, cardiogenic shock, hypoalbuminemia, and acute infection, were significant, independent predictors of postoperative delirium. Conclusions The results of this study can be used to develop a revised checklist of 29 preoperative, intraoperative, and postoperative risk factors for delirium, with special attention to the 4 predictive postoperative factors. Use of such a checklist may facilitate the ability to prevent or detect delirium early and provide suitable treatment.

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