Biomarkers and clinical features associated with pressure injury among geriatric patients

Khalid Elsayed Elsorady; Ahmed Hassan Nouh

doi:10.29333/ejgm/12636

Full Text (PDF)

Khalid Elsayed Elsorady ¹ ² ^* , Ahmed Hassan Nouh ³

More Detail

¹ Department of Geriatrics and Gerontology, Faculty of Medicine, Ain Shams University, Cairo, EGYPT² Geriatrics Hospital, Ain Shams University Hospitals, Abbasia, Cairo, EGYPT³ Department of Dermatology and Venereology, Al Azhar University, Cairo, EGYPT^* Corresponding Author

Abstract

Purpose: The study aims to identify biomarkers and clinical features associated with pressure injury (PI) among geriatric patients.
Methods: A cross-sectional study including 191 patients aged ≥60 years. Patients were classified into those with and without PI. Assessing the risk of PI was performed on admission by applying the Braden scale (BS) for predicting pressure sore risk. Clinical history, baseline hematology, and biochemistry results were obtained. C-reactive protein to albumin ratio (CAR) and Charlson comorbidity index (CCI) were calculated. Statistical analyses were performed.
Results: 43 (22.5%) patients had PI. PI was significantly associated with higher CCI, total leukocyte count, and CAR, besides lower BS scores, serum albumin, and total proteins. Significant comorbidities were diabetes mellitus, stroke/transient ischemic attack, dementia, incontinence, and chronic kidney disease. The optimal cut-offs for PI occurrence were ≤14, ≤3.1 g/dl and >1.27 for BS, albumin, and CAR, respectively.

Keywords

Braden scale
older adults
pressure Injury

License

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Article Type: Original Article

ELECTRON J GEN MED, 2023, Volume 20, Issue 1, Article No: em431

https://doi.org/10.29333/ejgm/12636

Publication date: 01 Jan 2023

Online publication date: 13 Nov 2022

Article Views: 983

Article Downloads: 953

Open Access References How to cite this article

References

Efraim J, Oded M. Dementia and pressure ulcers: Is there a close pathophysiological interrelation? J Alzheimers Dis. 2017;56(3):861-6. https://doi.org/10.3233/JAD-161134 PMid:28035938
Zhang X, Zhu N, Li Z, Xie X, Liu T, Ouyang G. The global burden of decubitus ulcers from 1990 to 2019. Sci Rep. 2021;11:21750. https://doi.org/10.1038/s41598-021-01188-4 PMid:34741095 PMCid:PMC8571371
Pan Pacific Pressure Injury Alliance. Prevention and treatment of pressure ulcers/injuries: Quick reference guide. EPUAP/NPIAP/PPPIA; 2019. Available at: https://internationalguideline.com/static/pdfs/Quick_Reference_Guide-10Mar2019.pdf (Accessed 19 August 2022).
NHS Improvement. Pressure ulcers: Revised definition and measurement framework summary and recommendations. 2018. Available at: https://www.england.nhs.uk/wp-content/uploads/2021/09/NSTPP-summaryrecommendations.pdf (Accessed 19 August 2022).
Li Z, Lin F, Thalib L, Chaboyer W. Global prevalence and incidence of pressure injuries in hospitalised adult patients: A systematic review and meta-analysis. Int J Nurs Stud. 2020;105:103546. https://doi.org/10.1016/j.ijnurstu.2020.103546 PMid:32113142
Borghardt AT, Prado TN, Araújo TM, Rogenski NM, Bringuente ME. Evaluation of the pressure ulcers risk scales with critically ill patients: A prospective cohort study. Rev Lat Am Enfermagem. 2015;23(1):28-35. https://doi.org/10.1590/0104-1169.0144.2521 PMid:25806628 PMCid:PMC4376028
Cohen RR, Lagoo-Deenadayalan SA, Heflin MT, et al. Exploring predictors of complication in older surgical patients: A deficit accumulation index and the Braden scale. J Am Geriatr Soc. 2012;60(9):1609-15. https://doi.org/10.1111/j.1532-5415.2012.04109.x PMid:22906222 PMCid:PMC3445658
Lima Serrano M, González Méndez MI, Carrasco Cebollero FM, Lima Rodríguez JS. Risk factors for pressure ulcer development in intensive care units: A systematic review. Med Intensiva. 2017;41(6):339-46. https://doi.org/10.1016/j.medin.2016.09.003
Chung ML, Widdel M, Kirchhoff J, et al. Risk factors for pressure injuries in adult patients: A narrative synthesis. Int J Environ Res Public Health. 2022;19(2):761. https://doi.org/10.3390/ijerph19020761 PMid:35055583 PMCid:PMC8776011
Goldstein RL, Walia P, Teylan M, et al. Clinical factors associated with C-reactive protein in chronic spinal cord injury. Spinal Cord. 2017;55(12):1088-95. https://doi.org/10.1038/sc.2017.81 PMid:28762383 PMCid:PMC5794634
Sun P, Chen C, Xia Y, et al. The Ratio of C-Reactive Protein/Albumin is a Novel Inflammatory Predictor of Overall Survival in Cisplatin-Based Treated Patients with Metastatic Nasopharyngeal Carcinoma. Dis Markers. 2017;6570808. https://doi.org/10.1155/2017/6570808 PMid:28676731 PMCid:PMC5476879
Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J Chronic Dis. 1987;40(5):373-83. https://doi.org/10.1016/0021-9681(87)90171-8
European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel. Prevention and treatment of pressure ulcers: Quick reference guide. 2009. Available at: https://www.epuap.org/guidelines/Final_Quick_Prevention.pdf (Accessed 19 August 2022).
Bergstrom N, Braden BJ, Laguzza A, Holman V. The Braden scale for predicting pressure sore risk. Nurs Res. 1987;36(4):205-10. https://doi.org/10.1097/00006199-198707000-00002 PMid:3299278
Ayello EA, Braden B. How and why to do pressure ulcer risk assessment. Adv Skin Wound Care. 2002;15(3):125-31; https://doi.org/10.1097/00129334-200205000-00008 PMid:12055446
Gillespie BM, Chaboyer W, McInnes E, Kent B, Whitty J, Thalib, L. Repositioning for pressure ulcer prevention in adults. Cochrane Database Syst Rev. 2014;2014(4): CD009958. https://doi.org/10.1002/14651858.CD009958
Wounds Australia. Prevention and treatment of pressure ulcers: Clinical practice guideline. 2016. Available at: https://www.awma.com.au/ptpu/index.php (Accessed 19 August 2022).
Huang C, Ma Y, Wang C, et al. Predictive validity of the Braden scale for pressure injury risk assessment in adults: A systematic review and meta-analysis. Nurs Open. 2021;8(5):2194-207. https://doi.org/10.1002/nop2.792 PMid:33630407 PMCid:PMC8363405
Montalcini T, Moraca M, Ferrom Y, et al. Nutritional parameters predicting pressure ulcers and short-term mortality in patients with minimal conscious state as a result of traumatic and non-traumatic acquired brain injury. J Transl Med. 2015;13:305. https://doi.org/10.1186/s12967-015-0660-4 PMid:26376778 PMCid:PMC4573301
Latimer S, Chaboyer W, Thalib L, McInnes E, Bucknall T, Gillespie BM. Pressure injury prevalence and predictors among older adults in the first 36 hours of hospitalisation. J Clin Nurs. 2019;28:4119-27. https://doi.org/10.1111/jocn.14967 PMid:31216388
Watkins AA, Castillo-Angeles M, Calvillo-Ortiz R, et al. Braden scale for pressure ulcer risk predicts rehabilitation placement after pancreatic resection. HPB (Oxford). 2019;21(7):923-7. https://doi.org/10.1016/j.hpb.2018.10.021 PMid:30606683
Lovicu E, Faraone A, Fortini A. Admission Braden scale score as an early independent predictor of in-hospital mortality among inpatients with COVID-19: A retrospective cohort study. Worldviews Evid Based Nurs. 2021;18(5):247-53. https://doi.org/10.1111/wvn.12526 PMid:34275200 PMCid:PMC8447426
Gul YG, Koprulu AS, Haspolat A, Uzman S, Toptas M, Kurtulus I. Is Braden scale reliable and sufficient to evaluate the risk of pressure ulcer occurrence in level 3 intensive care unit patients? JAREM. 2016;6:98-104. https://doi.org/10.5152/jarem.2016.969
Park KH, Choi H. Prospective study on incontinence-associated dermatitis and its severity instrument for verifying its ability to predict the development of pressure ulcers in patients with fecal incontinence. Int Wound J. 2016;13(Suppl 1):20-5. https://doi.org/10.1111/iwj.12549 PMid:26847935 PMCid:PMC7949835
Pakize O, Meryem Y, Ozlem Y. Investigation of the risk factors of pressure ulcers in intensive care unit patients: According to the Braden scale article. East J Med. 2016;21(1):1-9. https://doi.org/10.5505/ejm.2016.21939
Bazaliñski D, Midura B, Wójcik A, Wiêch P. Selected biochemical blood parameters and a risk of pressure ulcers in patients receiving treatment in intensive care units. Medicina (Kaunas). 2021;57(2):177. https://doi.org/10.3390/medicina57020177 PMid:33669609 PMCid:PMC7922769
Pieper B, Sugrue M, Weiland M, Sprague K, Heiman C. Risk factors, prevention methods, and wound care for patients with pressure ulcers. Clin Nurse Spec. 1998;12(1):7-12. https://doi.org/10.1097/00002800-199801000-00005 PMid:9481258
Hatanaka N, Yamamoto Y, Ichihara K, et al. A new predictive indicator for development of pressure ulcers in bedridden patients based on common laboratory tests results. J Clin Pathol. 2008;61(4):514-8. https://doi.org/10.1136/jcp.2007.050195 PMid:18375746
Nassaji M, Askari Z, Ghorbani R. Cigarette smoking and risk of pressure ulcer in adult intensive care unit patients. Int J Nurs Pract. 2014;20(4):418-23. https://doi.org/10.1111/ijn.12141 PMid:25157943
Campos SF, Chagas AC, Costa AB, França RE, Jansen AK. Factors associated with the development of pressure ulcers: The impact of nutrition. Rev Nutr. 2010;23(5):703-14. https://doi.org/10.1590/S1415-52732010000500002
Raeder K, Jachan DE, Müller-Werdan U, Lahmann NA. Prevalence and risk factors of chronic wounds in nursing homes in Germany: A cross-sectional study. Int Wound J. 2020;17(5):1128-34. https://doi.org/10.1111/iwj.13486 PMid:32815303 PMCid:PMC7949346
Jaul E, Meiron O, Menczel J. The effect of pressure ulcers on the survival in patients with advanced dementia and comorbidities. Exp Aging Res. 2016;42(4):382-9. https://doi.org/10.1080/0361073X.2016.1191863 PMid:27410245
Jaul E, Barron J, Rosenzweig JP, Menczel J. An overview of co-morbidities and the development of pressure ulcers among older adults. BMC Geriatr. 2018;18(1):305. https://doi.org/10.1186/s12877-018-0997-7 PMid:30537947 PMCid:PMC6290523
Lachenbruch C, Ribble D, Emmons K, VanGilder C. Pressure ulcer risk in the incontinent patient: Analysis of incontinence and hospital-acquired pressure ulcers from the international pressure ulcer prevalence™ survey. J Wound Ostomy Continence Nurs. 2016;43(3):235-41. https://doi.org/10.1097/WON.0000000000000225 PMid:27167317
Gray M, Bliss DZ, Doughty DB, Ermer-Seltun J, Kennedy-Evans KL, Palmer MH. Incontinence-associated dermatitis: A consensus. J Wound Ostomy Continence Nurs. 2007;34(1):45-54. https://doi.org/10.1097/00152192-200701000-00008 PMid:17228207
O’Brien DD, Shanks AM, Talsma A, Brenner PS, Ramachandran SK. Intraoperative risk factors associated with postoperative pressure ulcers in critically ill patients: A retrospective observational study. Crit Care Med. 2014;42(1):40-7. https://doi.org/10.1097/CCM.0b013e318298a849 PMid:23982023
Suttipong C, Sindhu S. Predicting factors of pressure ulcers in older Thai stroke patients living in urban communities. J Clin Nurs. 2012;21(3-4):372-9. https://doi.org/10.1111/j.1365-2702.2011.03889.x PMid:22082321
Lyder CH, Wang Y, Metersky M, et al. Hospital-acquired pressure ulcers: Results from the national medicare patient safety monitoring system study. J Am Geriatr Soc. 2012;60(9):1603-8. https://doi.org/10.1111/j.1532-5415.2012.04106.x PMid:22985136

How to cite this article

Vancouver

Elsorady KE, Nouh AH. Biomarkers and clinical features associated with pressure injury among geriatric patients. ELECTRON J GEN MED. 2023;20(1):em431. https://doi.org/10.29333/ejgm/12636

APA

Elsorady, K. E., & Nouh, A. H. (2023). Biomarkers and clinical features associated with pressure injury among geriatric patients. Electronic Journal of General Medicine, 20(1), em431. https://doi.org/10.29333/ejgm/12636

AMA

Elsorady KE, Nouh AH. Biomarkers and clinical features associated with pressure injury among geriatric patients. ELECTRON J GEN MED. 2023;20(1), em431. https://doi.org/10.29333/ejgm/12636

Chicago

Elsorady, Khalid Elsayed, and Ahmed Hassan Nouh. "Biomarkers and clinical features associated with pressure injury among geriatric patients". Electronic Journal of General Medicine 2023 20 no. 1 (2023): em431. https://doi.org/10.29333/ejgm/12636

Harvard

Elsorady, K. E., and Nouh, A. H. (2023). Biomarkers and clinical features associated with pressure injury among geriatric patients. Electronic Journal of General Medicine, 20(1), em431. https://doi.org/10.29333/ejgm/12636

MLA

Elsorady, Khalid Elsayed et al. "Biomarkers and clinical features associated with pressure injury among geriatric patients". Electronic Journal of General Medicine, vol. 20, no. 1, 2023, em431. https://doi.org/10.29333/ejgm/12636