The relationship between arterial partial pressure of oxygen and pressure injuries in intensive care unit patients: A multi-center cross-sectional study

IF 4.9 2区医学 Q1 NURSING Intensive and Critical Care Nursing Pub Date : 2024-09-26 DOI:10.1016/j.iccn.2024.103785

{"title":"The relationship between arterial partial pressure of oxygen and pressure injuries in intensive care unit patients: A multi-center cross-sectional study","authors":"","doi":"10.1016/j.iccn.2024.103785","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Pressure injuries significantly impact patients in intensive care units and the healthcare system. Hypoxia, a major contributor to pressure injury development, can be promptly identified by monitoring arterial partial pressure of oxygen. However, the dose–response relationship between arterial partial pressure of oxygen and pressure injuries remains unclear.</div></div><div><h3>Objectives</h3><div>To determine how mean arterial partial pressure of oxygen within 24 h before the appearance of a pressure injury influences pressure injury outcomes in ICU patients, elucidating the dose–response relationship, and underscoring the importance of including arterial oxygen pressure in routine pressure injury risk assessments.</div></div><div><h3>Methods</h3><div>We conducted this multi-center cross-sectional study in Gansu province of China from April 2021 to July 2023. The incidence and influencing factors of pressure injuries were collected. Logistic and restricted cubic spline regression analyses were used to assess the association between pressure injuries and arterial partial pressure of oxygen. Subgroup analyses stratified by age and sex were conducted to explore potential correlations.</div></div><div><h3>Results</h3><div>Among 6078 participants, the incidence of pressure injury was 2.34 %. After adjusting for all confounding factors, patients with low arterial partial pressure of oxygen were more likely to develop pressure injury than those with normal levels (OR 1.753, 95 %CI 1.142 ∼ 2.693). The dose–response relationship shows a significant non-linear dose–response correlation between arterial partial pressure of oxygen and pressure injury risk (<em>P</em> = 0.011). Layered analysis shows that the impact is more pronounced in older individuals and males.</div></div><div><h3>Conclusions</h3><div>As arterial partial pressure of oxygen decreases, the occurrence of pressure injuries gradually increases. Incorporating arterial partial pressure of oxygen into daily pressure injury risk assessments is crucial.</div></div><div><h3>Implications for clinical practice</h3><div>Our study results will offer targeted insights for the prevention and management of pressure injuries.</div></div>","PeriodicalId":51322,"journal":{"name":"Intensive and Critical Care Nursing","volume":null,"pages":null},"PeriodicalIF":4.9000,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Intensive and Critical Care Nursing","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0964339724001708","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"NURSING","Score":null,"Total":0}

引用次数: 0

Abstract

Background

Pressure injuries significantly impact patients in intensive care units and the healthcare system. Hypoxia, a major contributor to pressure injury development, can be promptly identified by monitoring arterial partial pressure of oxygen. However, the dose–response relationship between arterial partial pressure of oxygen and pressure injuries remains unclear.

Objectives

To determine how mean arterial partial pressure of oxygen within 24 h before the appearance of a pressure injury influences pressure injury outcomes in ICU patients, elucidating the dose–response relationship, and underscoring the importance of including arterial oxygen pressure in routine pressure injury risk assessments.

Methods

We conducted this multi-center cross-sectional study in Gansu province of China from April 2021 to July 2023. The incidence and influencing factors of pressure injuries were collected. Logistic and restricted cubic spline regression analyses were used to assess the association between pressure injuries and arterial partial pressure of oxygen. Subgroup analyses stratified by age and sex were conducted to explore potential correlations.

Results

Among 6078 participants, the incidence of pressure injury was 2.34 %. After adjusting for all confounding factors, patients with low arterial partial pressure of oxygen were more likely to develop pressure injury than those with normal levels (OR 1.753, 95 %CI 1.142 ∼ 2.693). The dose–response relationship shows a significant non-linear dose–response correlation between arterial partial pressure of oxygen and pressure injury risk (P = 0.011). Layered analysis shows that the impact is more pronounced in older individuals and males.

Conclusions

As arterial partial pressure of oxygen decreases, the occurrence of pressure injuries gradually increases. Incorporating arterial partial pressure of oxygen into daily pressure injury risk assessments is crucial.

Implications for clinical practice

Our study results will offer targeted insights for the prevention and management of pressure injuries.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

重症监护室患者动脉血氧分压与压力损伤之间的关系：多中心横断面研究

背景压力性损伤对重症监护病房的患者和医疗保健系统造成严重影响。缺氧是导致压力性损伤的主要因素，可通过监测动脉血氧分压及时发现。目的确定压力性损伤出现前 24 小时内平均动脉血氧分压对 ICU 患者压力性损伤结果的影响，阐明剂量-反应关系，并强调将动脉血氧分压纳入常规压力性损伤风险评估的重要性。方法我们于 2021 年 4 月至 2023 年 7 月在甘肃省开展了这项多中心横断面研究。收集了压力性损伤的发生率和影响因素。采用逻辑回归分析和限制性三次样条回归分析评估压力性损伤与动脉血氧分压之间的关系。结果在 6078 名参与者中，压力性损伤的发生率为 2.34%。在调整了所有干扰因素后，动脉血氧分压过低的患者比动脉血氧分压正常的患者更容易发生压力性损伤（OR 1.753, 95 %CI 1.142 ∼ 2.693）。剂量-反应关系显示，动脉血氧分压与压力损伤风险之间存在显著的非线性剂量-反应相关性（P = 0.011）。分层分析表明，这种影响对老年人和男性更为明显。我们的研究结果将为压力性损伤的预防和管理提供有针对性的见解。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Intensive and Critical Care Nursing NURSING-

CiteScore

6.30

自引率

15.10%

发文量

144

审稿时长

57 days

期刊介绍： The aims of Intensive and Critical Care Nursing are to promote excellence of care of critically ill patients by specialist nurses and their professional colleagues; to provide an international and interdisciplinary forum for the publication, dissemination and exchange of research findings, experience and ideas; to develop and enhance the knowledge, skills, attitudes and creative thinking essential to good critical care nursing practice. The journal publishes reviews, updates and feature articles in addition to original papers and significant preliminary communications. Articles may deal with any part of practice including relevant clinical, research, educational, psychological and technological aspects.