A Retrospective study of Pressure ulcers in critically ill patients in a Sub-Saharan Tertiary Centre

Abstract

Background: Critically ill patients are at increased risk of developing pressure ulcers because of the presence of confounding factors such as reduced mobility, poor nutrition, reduced tissue perfusion, neurologic deficits, faecal or urinary incontinence. This study determined the prevalence and risk factors for the development of pressure ulcer in the ICU. 

Methods: A retrospective study of 499 critically ill patients from January 2010 to December 2012. Patients were excluded if they were admitted into the ICU for less than 48 hours or had a pressure ulcer at the time of admission. 

Result: A total of 499 patients with mean age for of 34.95±18.48 years, (3months to 89years) were studied. Adults were 419(83.97%). The mean duration of ICU admission was 7.30±(SEM)0.43 days. The prevalence of pressure ulcer was 86(17.23%). The mean onset and duration of pressure ulcer was 3.55±2.11 and 6.44±(SEM)1.11 days respectively. The majority of the ulcers 57(66.28%) were located in the sacrococcygeal region, followed by head and neck region, 19(22.09%). The risk of development of pressure ulcers was higher in neurological pathology, odd ratio 1.985, (95% CI 1.242 3.173), p = 0.004, duration of ICU admission >3days, odd ratio 9.143, (95% CI 3.898 21.445), p<0.001, and mechanical ventilation, odd ratio 0.80 (95% CI 0.45-0.141), p <0. 001. The occurrence of pressure ulcers was significantly associated with poor ICU outcome, odd ratio 2.408, (95% CI 1.474-3.933), p<0.001. 

Conclusion: Pressure ulcer is not uncommon in our ICU, therefore, there is a need to put in place guidelines and protocols to minimize the occurrence. 

Keywords: Pressure ulcer, prevalence, risk factors, intensive care unit.