Patricia Tasha Champagne, Yi-Ting Tzen, Jijia Wang, Bridget Bennett, Dominique Van Beest, Wei-Han Tan
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引用次数: 0
Abstract
Objective: The purpose of this study is to investigate predictors of pressure injury (PrI) outcomes at one year after discharge for Veterans with spinal cord injury (SCI) hospitalized with a Stage 3 or 4 PrI.
Design/setting/participants: This is a retrospective medical record review from one VA Health Care System SCI unit. Participants were Veterans with traumatic or non-traumatic SCI admitted with one Stage 3 or 4 pelvic PrI treated medically (e.g. without flap surgery). Logistic models were used to select the significant predictors of PrI healing outcomes.
Outcome measure: One year after discharge wound outcomes (healed vs non-healed) for Veterans with SCI hospitalized with a Stage 3 or 4 PrI.
Results: A total of 62 hospitalizations were included for analyses resulting in 33 healed and 29 non-healed PrIs. Three significant predictors of non-healed PrI outcomes included use of pressure mapping during hospitalization, greater PrI depth, and usage of alginate dressings. Two significant predictors of healed PrI outcomes included the use of animal-based tissue and hydrocolloid dressings. Area under curve of this logistic regression model was 79.98%.
Conclusion: The clinical decision of having a patient pressure mapped predicts that the PrI may not heal at one year of discharge. Pressure mapping protocol correlated with another variable that could not serve as a predictor by itself, including using powered pressure relief techniques. The three PrI treatment predictors may represent characteristics of the PrI itself, rather than the efficacy of the product. Further investigation on these clinical decision-making factors is warranted to ensure efficient and cost-effective treatment strategies for individuals with SCI hospitalized with PrIs.
研究目的本研究旨在调查脊髓损伤（SCI）退伍军人出院一年后压力损伤（PrI）结果的预测因素：这是一项来自退伍军人医疗保健系统 SCI 病房的回顾性病历审查。参与者为患有创伤性或非创伤性 SCI 的退伍军人，入院时骨盆 PrI 为 3 期或 4 期，采用药物治疗（如不进行皮瓣手术）。使用逻辑模型选择 PrI 愈合结果的重要预测因素：结果：共纳入了 62 例住院治疗的 SCI 退伍军人，他们的伤口愈合情况（愈合与未愈合）：共纳入 62 例住院患者进行分析，结果显示 33 例 PrI 愈合，29 例未愈合。未愈合 PrI 结果的三个重要预测因素包括住院期间使用压力测绘、PrI 深度较大以及使用藻酸盐敷料。对痊愈的 PrI 结果有两个重要的预测因素，包括使用动物组织和水胶体敷料。该逻辑回归模型的曲线下面积为 79.98%：让患者进行压力测绘的临床决定预示着 PrI 在出院一年后可能不会痊愈。压力测绘方案与另一个本身不能作为预测因素的变量相关，包括使用动力压力释放技术。这三个 PrI 治疗预测因子可能代表了 PrI 本身的特征，而不是产品的疗效。有必要对这些临床决策因素进行进一步研究，以确保为因 PrI 而住院的 SCI 患者制定高效且具有成本效益的治疗策略。
期刊介绍：
For more than three decades, The Journal of Spinal Cord Medicine has reflected the evolution of the field of spinal cord medicine. From its inception as a newsletter for physicians striving to provide the best of care, JSCM has matured into an international journal that serves professionals from all disciplines—medicine, nursing, therapy, engineering, psychology and social work.
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