중환자의 영양 상태가 욕창과 사망 위험에 미치는 영향
Impact of Nutritional Status on Pressure Ulcers and Death among Critically Ill Patients
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Objectives: This study determined the impact of nutritional status on pressure ulcers and death among critically ill patients. Methods: The secondary data of 247 critically ill patients were retrospectively collected from the electronic medical record at a university hospital-affiliated intensive care units. Nutritional status was classified by normal nutrition, moderate malnutrition, and severe malnutrition using the Patient Generative Global Subjective Assessment. Pressure ulcers was assessed using the Braden Scale at the admission day and day 7. The 3-month death was evaluated from the intensive care units admission. Data were analyzed χ test, McNemar test, Kruskal-Wallis test with Bonferroni’s comparison and logistic regression. Results: Moder- 2 ate and severe malnourished patients were 60.2% and 13.4%, respectively. The prevalence of pressure ulcer was 20.3% at day 7. The 3-month death rate was 21.1%. Body weight loss, oral intake reduction, poor masticatory function, nausea, prevalence of pressure ulcers, and death rate were higher in the severe malnourished patients. Moderate and severe malnutrition affected higher prevalence of pressure ulcers (odds ratio, OR: 3.83, 95% confidence interval, CI: 1.20-12.20; 2.83, 95% CI: 1.23-6.49). Pressure ulcers affected higher death rate (OR: 2.48, 95% CI: 1.22-5.08). Moderate and severe malnutrition were associated with higher death rate (OR: 7.14, 95% CI: 2.17-23.81; OR: 2.46, 95% CI: 1.09-5.53). Conclusions: A targeted nutritional management pro- gram based on malnourished stages may be helpful to reduce the risks of pressure ulcers and death among critically ill patients.
Abstract
Objectives: This study determined the impact of nutritional status on pressure ulcers and death among critically ill patients. Methods: The secondary data of 247 critically ill patients were retrospectively collected from the electronic medical record at a university hospital-affiliated intensive care units. Nutritional status was classified by normal nutrition, moderate malnutrition, and severe malnutrition using the Patient Generative Global Subjective Assessment. Pressure ulcers was assessed using the Braden Scale at the admission day and day 7. The 3-month death was evaluated from the intensive care units admission. Data were analyzed χ test, McNemar test, Kruskal-Wallis test with Bonferroni’s comparison and logistic regression. Results: Moder- 2 ate and severe malnourished patients were 60.2% and 13.4%, respectively. The prevalence of pressure ulcer was 20.3% at day 7. The 3-month death rate was 21.1%. Body weight loss, oral intake reduction, poor masticatory function, nausea, prevalence of pressure ulcers, and death rate were higher in the severe malnourished patients. Moderate and severe malnutrition affected higher prevalence of pressure ulcers (odds ratio, OR: 3.83, 95% confidence interval, CI: 1.20-12.20; 2.83, 95% CI: 1.23-6.49). Pressure ulcers affected higher death rate (OR: 2.48, 95% CI: 1.22-5.08). Moderate and severe malnutrition were associated with higher death rate (OR: 7.14, 95% CI: 2.17-23.81; OR: 2.46, 95% CI: 1.09-5.53). Conclusions: A targeted nutritional management pro- gram based on malnourished stages may be helpful to reduce the risks of pressure ulcers and death among critically ill patients.
참고문헌 (33)
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