Incidencia y factores de riesgo para el desarrollo de úlceras por presión en la unidad de cuidados intensivos del Hospital Universitario Virgen del Rocío

Résumé

Pressure ulcers (PU) represent a health problem with a significant impact on patients' morbidity and mortality and the quality of life of the affected individuals and their families. Patients admitted to intensive care units (ICU) have a particularly high risk of developing PU with an incidence ranging from 3.3% to 52.9%. Objective: To determine the incidence of pressure ulcers and to identify the risk factors associated with its development in the critical patient. Patients and Methods: An observational, longitudinal and prospective cohort study was designed in the clinical setting of an ICU with 62 beds. 335 patients were enrolled in two study periods of one month duration each of them. As the main or dependent variable, the occurrence of PU in stages I to IV was considered. For the study of risk factors, four categories were considered: demographic, clinical, prognostic and therapeutic variables. Results: The incidence of patients who developed UPP was 8.1%. Statistically significant variables for p values <0.05 were: sex, age, diabetes, complications during ICU stay, SAPS 3 scale score and duration of immobilization. These last three were shown in the multivariate model as explanatory variables. Conclusions: A greater severity of the disease usually demands a longer duration of stay in the ICU, which would expose patients' skin to conditions that favor the development of UPP. Likewise, complications in health care are associated with an increase in length of stay and health costs. The repositioning and the early mobilization, together with the other preventive measures, become fundamental to avoid the appearance of UPP in the environment of critical patient care.