Pressure ulcer development in patients treated for acute ischaemic stroke.

IF 1.5 4区医学 Q3 DERMATOLOGY Journal of wound care Pub Date : 2024-06-02 DOI:10.12968/jowc.2020.0331

Esin Derin Cicek, Ayper Önal Alkan, Nihan Parasiz Yukselen, Yılmaz Onal, Hakki Muammer Karakas, Ahmet Vural

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Abstract

Objective: The aim of this study was to determine the incidence of pressure ulcers (PUs) in patients treated for acute ischaemic stroke (AIS) and to evaluate comorbid/confounding factors.

Method: The study included patients treated for AIS who were divided into three treatment groups: those receiving intravenous tissue plasminogen activator therapy (tPA); patients receiving mechanical thrombectomy (MT); and those receiving both tPA and MT. PUs were classified according to the international classification system and factors that may influence their development were investigated.

Results: A total of 242 patients were included in this study. The incidence of PUs in patients treated for AIS was 7.4%. Most PUs were located on the sacrum (3.7%), followed by the gluteus (3.3%) and trochanter (2.9%). With regards to PU classification: 29% were stage I; 34% were stage II; and the remainder were stage III. Age was not a significant factor in the development of PUs (p=0.172). Patients in the tPA group had a lower PU incidence (2.3%) than patients in the tPA+MT group (15.7%) and MT group (12.1%) (p=0.001). Patients with PUs had a longer period of hospitalisation (18.5±11.92 days) than patients without a PU (8.0±8.52 days) (p=0.000). National Institute of Health Stroke Scale (NIHSS) scores at admission were higher in patients with PUs than in patients without a PU (14.33±4.38 versus 11.08±5.68, respectively; p=0.010). The difference in presence of comorbidities between patients with and without PUs (p=0.922) and between treatment groups (p=0.677) were not statistically significant. The incidence of PUs was higher in patients requiring intensive care, but this difference was not statistically significant (p=0.089).

Conclusion: In this study, patients treated for AIS with high NIHSS scores at admission and/or receiving MT were at higher risk for PUs, and so particular attention should be given to these patients in order to prevent PU development.

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接受急性缺血性中风治疗的患者出现褥疮。

研究目的本研究旨在确定急性缺血性中风（AIS）患者的压疮（PU）发生率，并评估合并症/诱发因素：研究对象包括接受急性缺血性中风（AIS）治疗的患者，这些患者被分为三个治疗组：接受静脉组织纤溶酶原激活剂治疗（tPA）的患者；接受机械性血栓切除术（MT）的患者；同时接受tPA和MT治疗的患者。PU根据国际分类系统进行分类，并对可能影响其发展的因素进行了调查：本研究共纳入 242 例患者。在接受AIS治疗的患者中，PU的发生率为7.4%。大多数 PU 位于骶骨（3.7%），其次是臀肌（3.3%）和转子（2.9%）。PU分类：29%为I期，34%为II期，其余为III期。年龄不是PU发病的重要因素（P=0.172）。tPA组患者的PU发生率（2.3%）低于tPA+MT组（15.7%）和MT组（12.1%）（P=0.001）。PU 患者的住院时间（18.5±11.92 天）长于无 PU 患者（8.0±8.52 天）（P=0.000）。PU 患者入院时的美国国立卫生研究院卒中量表（NIHSS）评分高于无 PU 患者（分别为 14.33±4.38 对 11.08±5.68；P=0.010）。PU患者与无PU患者在合并症方面的差异（P=0.922）以及治疗组之间的差异（P=0.677）均无统计学意义。需要重症监护的患者PU发生率较高，但这一差异无统计学意义（P=0.089）：在这项研究中，入院时NIHSS评分较高和/或接受MT治疗的AIS患者发生PU的风险较高，因此应特别关注这些患者，以预防PU的发生。

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来源期刊

Journal of wound care DERMATOLOGY-

CiteScore

2.90

自引率

10.50%

发文量

215

期刊介绍： Journal of Wound Care (JWC) is the definitive wound-care journal and the leading source of up-to-date research and clinical information on everything related to tissue viability. The journal was first launched in 1992 and aimed at catering to the needs of the multidisciplinary team. Published monthly, the journal’s international audience includes nurses, doctors and researchers specialising in wound management and tissue viability, as well as generalists wishing to enhance their practice. In addition to cutting edge and state-of-the-art research and practice articles, JWC also covers topics related to wound-care management, education and novel therapies, as well as JWC cases supplements, a supplement dedicated solely to case reports and case series in wound care. All articles are rigorously peer-reviewed by a panel of international experts, comprised of clinicians, nurses and researchers. Specifically, JWC publishes: High quality evidence on all aspects of wound care, including leg ulcers, pressure ulcers, the diabetic foot, burns, surgical wounds, wound infection and more The latest developments and innovations in wound care through both preclinical and preliminary clinical trials of potential new treatments worldwide In-depth prospective studies of new treatment applications, as well as high-level research evidence on existing treatments Clinical case studies providing information on how to deal with complex wounds Comprehensive literature reviews on current concepts and practice, including cost-effectiveness Updates on the activities of wound care societies around the world.