Characteristics of Patients Admitted to Vascular Surgery Service for a Major Lower Limb Amputation From 2017 to 2021 With Present on Admission Pressure Injuries.

IF 1.7 3区 医学 Q2 NURSING Journal of Wound Ostomy and Continence Nursing Pub Date : 2024-11-01 Epub Date: 2024-11-12 DOI:10.1097/WON.0000000000001121
Catherine R Ratliff, Virginia Rovnyak
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Abstract

Purpose: The purpose of this study was to describe characteristics of patients admitted from 2017 to 2021 with peripheral arterial disease (PAD) who required a below knee amputation (BKA) or above knee amputation (AKA), including present on admission pressure injuries (POA-PIs).

Design: Descriptive, cross-sectional retrospective research design.

Subjects and setting: The sample comprised 196 patients who underwent 258 major lower limb amputations. A majority (65.9 %n = 170) underwent BKAs and 88 (34.1 %) underwent AKAs. Coronary artery disease was present in 107 (54.6 %) and 143 (73.0%) had diabetes mellitus. The study site was a 670-bed level 1 trauma center in the Mid-Atlantic region of the United States.

Methods: A retrospective chart review of patients undergoing major lower limb amputations using CPT codes 27880 BKA, and 27590 AKA was completed. Variables extracted included age, sex, race, and comorbid conditions such as smoking, cardiovascular disease, diabetes mellitus, end stage renal disease requiring dialysis, and POA-PI. Descriptive statistics (frequencies, percentages, and means) were used to describe the sample.

Results: There were 25 (12.8%) individuals with POA-PI compared with 171 (87.2%) who did not have POA-PI. None of the characteristics reviewed significantly differed when patients with or without POA-PI were compared. Age was closest to statistical significance ( P = .052). In addition, analysis revealed that 73% (n = 143) of individuals had diabetes mellitus in addition to having PAD.

Conclusion: Approximately 13% of a group of patients with PAD had POA-PI when admitted to hospital for major limb amputation. Analysis of multiple factors found that none significantly differed between patients with or without POA-PI. Age came nearest to statistical significance and we hypothesize that older age may increase the risk for POA-PI; additional research in samples with greater power to detect this effect are needed. Findings also indicate that diabetes mellitus is a common risk factor for major lower limb amputation. It is important to educate staff/patients/caregivers on the importance of PI prevention especially in the elderly vascular population who are at risk for undergoing major lower limb amputations.

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2017 年至 2021 年因下肢大截肢而入住血管外科服务且入院时存在压力损伤的患者特征。
目的:本研究旨在描述2017年至2021年期间入院的患有外周动脉疾病(PAD)、需要进行膝下截肢(BKA)或膝上截肢(AKA)的患者的特征,包括入院时存在的压力损伤(POA-PIs):设计:描述性、横断面回顾性研究设计:样本包括接受过 258 例主要下肢截肢手术的 196 名患者。大多数患者(65.9%n=170)接受了BKA,88例(34.1%)接受了AKA。107人(54.6%)患有冠状动脉疾病,143人(73.0%)患有糖尿病。研究地点是美国东南部一家拥有 670 张床位的一级创伤中心:对使用 CPT 代码 27880 BKA 和 27590 AKA 进行下肢大截肢手术的患者进行了回顾性病历审查。提取的变量包括年龄、性别、种族和合并症,如吸烟、心血管疾病、糖尿病、需要透析的终末期肾病和 POA-PI。描述性统计(频率、百分比和平均值)用于描述样本:结果:25 人(12.8%)患有 POA-PI,而 171 人(87.2%)未患有 POA-PI。在对患有或未患有 POA-PI 的患者进行比较时,所审查的各项指标均无明显差异。年龄最接近统计学意义(P= 0.052)。此外,分析还显示,73%(n = 143)的患者除患有 PAD 外,还患有糖尿病:结论:在一组 PAD 患者中,约有 13% 的人在入院接受主要肢体截肢手术时患有 POA-PI。对多种因素的分析发现,有或没有 POA-PI 的患者之间没有明显差异。年龄最接近统计学意义,因此我们推测年龄越大,发生急性肢体缺损的风险就越高;我们需要在样本中进行更多的研究,以更大的力量来检测这种影响。研究结果还表明,糖尿病是主要下肢截肢的常见风险因素。教育员工/患者/护理人员认识到预防 PI 的重要性非常重要,尤其是对于有下肢截肢风险的老年血管病患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.10
自引率
34.60%
发文量
186
审稿时长
6-12 weeks
期刊介绍: ​​The Journal of Wound, Ostomy and Continence Nursing (JWOCN), the official journal of the Wound, Ostomy and Continence Nurses Society™ (WOCN®), is the premier publication for wound, ostomy and continence practice and research. The Journal’s mission is to publish current best evidence and original research to guide the delivery of expert health care. The WOCN Society is a professional nursing society which supports its members by promoting educational, clinical and research opportunities to advance the practice and guide the delivery of expert health care to individuals with wounds, ostomies and continence care needs.
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