excluded because pressure ulcers generally develop more than 72 hours after

Excluded because pressure ulcers generally develop

This preview shows page 3 - 5 out of 9 pages.

excluded, because pressure ulcersgenerally develop more than 72hours after admission.28,29Admission and dischargediagnoses were reviewed to iden-tify patients in whom a pressureulcer developed during hospital-ization because data on pressureulcers that developed during theICU stay were not available. Dataon patients who had a pressure ulcer at the time ofhospital admission were excluded. If a patient’s dis-charge diagnoses included pressure ulcer, the patientwas considered “pressure ulcer present.” If the diag-noses did not include pressure ulcer, the patient wasconsidered “pressure ulcer absent.” BMI is calculated on the basis of a person’s weightand height.30BMI values could not be calculated forindividual patients in the study because height infor-mation for the ICU patients was not available. Asan alternative, BMI data from the discharge diagnoseswere used. BMI information had been recorded inthe electronic health records by using codes fromthe International Classification of Diseases, Ninth Revi-sion,31upon hospital discharge. For instance, patientswhose BMIs were less than 19 were coded as V85.0and those whose BMIs were between 39.0 and 39.9were coded as V85.39. The coding system addition-ally included more specific BMI codes, such as V85.43for BMI between 50.0 and 59.9 and V85.45 for BMIof 70 and greater.Data AnalysisPatients were classified into 4 BMI groups: under-weight, normal weight, obese, and extremely obese.The classification was made by referring to the BMIcategorization of the National Heart, Lung, and BloodInstitute.30The groups were defined as follows:496AJCCAMERICAN JOURNAL OF CRITICAL CARE, November 2014, Volume 23, No. 6Data on bodymass index wereobtained fromdiagnostic codesupon hospitaldischarge.
Background image
Other types of admission diagnoses were representedby less than 1% of the sample.According to total scores on the Braden scale,62% of patients (n=1642) were at risk for pressureulcers (score ≤ 18) at the time of ICU admission.Twenty-nine percent of patients (n=753) were clas-sified as high risk (score 10-12) or very high risk(score ≤ 9). The incidence of pressure ulcers was5.6% (n=147).Association Between BMI and Incidence ofPressure UlcersAmong the patients in the sample, 7.5% (n=197)were underweight, 17.9% (n=470) were normalweight, 48.5% (n=1277) were obese, and 26.1% (n=688) were extremely obese. Table 2 summarizescharacteristics of the 4 groups. The rates of pressureulcers in the underweight, normal weight, obese, andextremely obese groups were 8.6%, 5.5%, 2.8%,and 9.9%, respectively.In paired comparisons between the groups, nor-mal weight and underweight groups did not differin age, sex, and length of ICU stay. However, under-weight patients had lower total scores on the Bradenscale than did normal weight patients (P=.003),indicating a higher risk for pressure ulcers in theunderweight patients. The incidence of pressure ulcersdid not differ significantly between the underweightAJCCAMERICAN JOURNAL OF CRITICAL CARE, November 2014, Volume 23, No. 6497Table 1Demographics of patients in the intensive care unitaSexMaleFemale
Background image
Image of page 5

You've reached the end of your free preview.

Want to read all 9 pages?

  • Fall '16
  • Denise Cauble
  • Nursing

What students are saying

  • Left Quote Icon

    As a current student on this bumpy collegiate pathway, I stumbled upon Course Hero, where I can find study resources for nearly all my courses, get online help from tutors 24/7, and even share my old projects, papers, and lecture notes with other students.

    Student Picture

    Kiran Temple University Fox School of Business ‘17, Course Hero Intern

  • Left Quote Icon

    I cannot even describe how much Course Hero helped me this summer. It’s truly become something I can always rely on and help me. In the end, I was not only able to survive summer classes, but I was able to thrive thanks to Course Hero.

    Student Picture

    Dana University of Pennsylvania ‘17, Course Hero Intern

  • Left Quote Icon

    The ability to access any university’s resources through Course Hero proved invaluable in my case. I was behind on Tulane coursework and actually used UCLA’s materials to help me move forward and get everything together on time.

    Student Picture

    Jill Tulane University ‘16, Course Hero Intern

Stuck? We have tutors online 24/7 who can help you get unstuck.
A+ icon
Ask Expert Tutors You can ask You can ask You can ask (will expire )
Answers in as fast as 15 minutes