Author(s):
Sardo, Pedro Miguel Garcez ; Guedes, Jenifer Adriana Domingues ; Alvarelhão, José Joaquim Marques ; Machado, Paulo Alexandre Puga ; Melo, Elsa Maria Oliveira Pinheiro
Date: 2018
Persistent ID: http://hdl.handle.net/10400.26/33062
Origin: Escola Superior de Enfermagem do Porto
Subject(s): Adult; Aged; Aged, 80 and over; Cohort Studies; Female; Hospitalization; Humans; Length of Stay; Male; Middle Aged; Patients' Rooms; Physical Examination; Portugal; Pressure Ulcer; Proportional Hazards Models; Retrospective Studies; Risk Assessment; Risk Factors; Incidence
Description
Aim: To study the influence of Braden subscales scores (at the first pressure ulcer risk assessment) on pressure ulcer incidence using a univariate and a multivariate time to event analysis. Materials and methods: Retrospective cohort analysis of electronic health record database from adult patients admitted without pressure ulcer(s) to medical and surgical wards of a Portuguese hospital during 2012. The hazard ratio of developing a pressure ulcer during the length of inpatient stay was calculated by univariate Cox regression for each variable of interest and by multivariate Cox regression for the Braden subscales that were statistically significant. Results: This study included a sample of 6552 participants. During the length of stay, 153 participants developed (at least) one pressure ulcer, giving a pressure ulcer incidence of 2.3%. The univariate time to event analysis showed that all Braden subscales, except “nutrition”, were associated with the development of pressure ulcer. By multivariate analysis the scores for “mobility” and “activity” were independently predictive of the development of pressure ulcer(s) for all participants. Conclusion: (Im)“mobility” (the lack of ability to change and control body position) and (in)“activity” (the limited degree of physical activity) were the major risk factors assessed by Braden Scale for pressure ulcer development during the length of inpatient stay. Thus, the greatest efforts in managing pressure ulcer risk should be on “mobility” and “activity”, independently of the total Braden Scale score.
