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Overview :
Eachempati et al identified risk factors for development of
decubitus ulcers by surgical patients in the intensive care unit (ICU). These
factors can help identify those patients who may require interventions to
prevent development of the ulcers. The authors are from New York-Presbyterian
Hospital.
Risk factors:
(1) emergency admission
(2) age
(3) days in bed (ambulatory status)
(4) length of stay in the ICU
An emergency admission the most significant risk factor,
showing an odds ratio of 36.
Based on the data in Table 4, the risk is associated with:
(1) age >= 69
(2) nonambulatory >= 12 days
(3) length of
stay in the ICU >= 15 days (although the paper infers increased risk for a
length of stay > 7 days)
While days without nutrition was also listed as a risk
factor for development of decubitus ulcers, patients who developed ulcers went
without nutritional support an average of 1.9 days vs 4.3 for the nonulcer
group, with an odds ratio of 0.51. This might suggest that days without
nutrition was protective. This is counter-intuitive and may reflect a clinical
malnutrition in the ucler group (with the need to start nutritional support
sooner). For the implementation I have substituted malnutrition as a risk
factor.
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