신경외과 수술 환자의 수술 관련 욕창 발생 위험요인
Risk Factors of Pressure Injury related to Surgery in Neurosurgery Patients
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
목적: 본 연구의 목적은 신경외과 수술을 받은 환자를 대상으로 수술 관련 욕창 발생 위험요인을 확인하는 것이다. 방법: 본 연구는 2015년부터 2021년까지 일개 종합병원 병동에 입원한 신경외과 수술 환자를 대상으로 한 후향적 사례-대조군 연구이다. 자료 수집은 2021년 9월 1일부터 30일까지 시행하였으며 수집한 자료는 IBM SPSS/WIN 26.0 프로그램을 사용하여 분석하였다. 결과: 신경외과 수술환자의 수술 관련 욕창 발생에 영향을 미치는 위험요인은 고혈압(OR=3.12, p=.024), 수술 후 낮은 알부민 수치(OR=0.30, p=.028), 장시간의 수술(OR=1.00, p=.001)이다. 회귀모형을 분석한 결과 분류 정확도는 86.0%로 나타났다. 결론: 신경외과 수술환자의 수술 관련 욕창을 예방하기 위해서는 철저한 혈압 관리, 적극적인 알부민 수치 교정, 수술시간을 고려한 예방적 간호 중재가 필요하다.
Abstract
Purpose: The purpose of this study was to evaluate risk factors of pressure injuries in patients after neurosurgery. Methods: A retrospective case-control study was conducted using 273 patients undergoing neurosurgery admitted to a general hospital from 2015 to 2021. Data were collected from September 1 to 30, 2021. The data were analyzed using the SPSS/WIN 26.0 program. Results: Risk factors significantly influencing the occurrence of pressure injuries in the patients undergoing neurosurgery were hypertension (OR=3.12, p=.024), postoperative hypoalbuminemia (OR=0.30, p=.028), and prolonged operative duration (OR=1.00, p=.001). The regression model explained 86.0% of the variance of the outcome variable. Conclusion: In order to prevent surgery-related pressure injuries in patients undergoing neurosurgery, thorough blood pressure management, avoidance of hypoalbuminemia, and preventive nursing intervention considering operative duration are required.
참고문헌 (29)
- Suh DaeHee, "An exploratory study of risk factors for pressure injury in patients undergoing spine surgery", Anesthesia and Pain Medicine, 16(1), pp.108~115 (2021), 대한마취통증의학회[DOI]
- 곽혜란, "중환자실 환자의 입실 시 욕창 유병률과 위험요인", 성인간호학회지, 27(3), pp.347~357 (2015), 한국성인간호학회[DOI]
- Walker RM, "Prevention and treatment of pressure injuries : A meta-synthesis of Cochrane reviews", Journal of Tissue Viability, 29(4), pp.227~243 (2020)[DOI]
- 이준호, "욕창의 사회경제적 영향", 대한의사협회지, 64(1), pp.11~15 (2021), 대한의사협회
- Aloweni F, "A prediction tool for hospital-acquired pressure ulcers among surgical patients : Surgical pressure ulcer risk score", International Wound Journal, 16(1), pp.164~175 (2019)[DOI]
- Cox J, "Predictors of pressure ulcers in adult critical care patients", American Journal of Critical Care, 20(5), pp.364~375 (2011)[DOI]
- 김정민, "Perioperative factors associated with pressure ulcer development after major surgery", Korean Journal of Anesthesiology, 71(1), pp.48~56 (2018), 대한마취통증의학회
- Ramezanpour E, "Incidence and risk factors of pressure ulcers among general surgery patients", Journal of Nursing and Midwifery Sciences, 5(4), pp.159~164 (2018)[DOI]
- Primiano M, "Pressure ulcer prevalence and risk factors during prolonged surgical procedures", AORN Journal, 94(6), pp.555~566 (2011)[DOI]
- Lin S, "Prevalence and predictors of pressure injuries from spine surgery in the prone position", Spine, 42(22), pp.1730~1736 (2017)[DOI]
- Lumbley JL, "Retrospective review of predisposing factors for intraoperative pressure ulcer development", Journal of Clinical Anesthesia, 26(5), pp.368~374 (2014)[DOI]
- 이종경, "Braden scale을 이용한 신경외과 중환자의 욕창 위험 요인 사정과 욕창 발생과의 관계", 성인간호학회지, 15(2), pp.267~277 (2003), 한국성인간호학회
- 김경남, "일개 대학병원 입원환자의 욕창 실태와 욕창상태 영향요인", 임상간호연구, 17(3), pp.433~442 (2011), 병원간호사회
- 신경림, "노인요양병원 욕창위험군의 욕창발생에 영향을 미치는 시설요인 및 간호요인", 노인간호학회지, 14(1), pp.29~38 (2012), 한국노인간호학회[DOI]
- 이순진, "고관절 골절로 입원한 노인 환자의 욕창 발생 위험요인", Journal of Korean Biological Nursing Science, 21(1), pp.54~61 (2019), 한국기초간호학회[DOI]
- 양태영, "신경외과 수술 환자에서 발생되는 의료기기 관련 압력 손상의 발생률 및 위험요인", 성인간호학회지, 33(3), pp.226~235 (2021), 한국성인간호학회[DOI]
- Jung YJ, "Risk factors for pressure ulcer in severe trauma patients", Journal of Acute Care Surgery, 5(1), pp.19~27 (2015)[DOI]
- 이하늬, "중환자실 환자의 욕창을 예측하는 영양 관련 요인", 기본간호학회지, 21(4), pp.413~422 (2014), 기본간호학회[DOI]
- 윤혜선, "노인요양기관의 욕창발생 위험요인과 욕창예방 관리: 혼합연구", 한국산학기술학회논문지, 21(3), pp.147~155 (2020), 한국산학기술학회[DOI]
- Defloor T, "Preventing pressure ulcers : An evaluation of four operating-table mattresses", Applied Nursing Research, 13(3), pp.134~141 (2000)[DOI]
- Grimes DA, "Compared to what? Finding controls for case-control studies", Lancet, 365(9468), pp.1429~1433 (2005)[DOI]
- "NPIAP pressure injury stages" (2016)[URL]
- Bergstrom N, "A clinical trial of the Braden scale for predicting pressure sore risk", Nursing Clinics of North America, 22(2), pp.417~428 (1987)
- Gao L, "The use of a logistic regression model to develop a risk assessment of intraoperatively acquired pressure ulcer", Journal of Clinical Nursing, 27(15-16), pp.2984~2992 (2018)[DOI]
- Mehta C, "Pressure ulcer and patient characteristics-A point prevalence study in a tertiary hospital of India based on the European Pressure Ulcer Advisory Panel minimum data set", Journal of Tissue Viability, 24(3), pp.123~130 (2015)[DOI]
- Engels D, "Pressure ulcers : Factors contributing to their development in the OR", AORN Journal, 103(3), pp.271~281 (2016)[DOI]
- He W, "The Braden scale can't be used alone for assessing pressure ulcer risk in surgical patients : A metaanalysis", Ostomy-Wound Management, 58(2), pp.34~40 (2012)
- Li D, "Reliability and validity Munro scale on the assessment of pressure ulcer risks in adult perioperative patients : A cross-sectional study", International Journal of Clinical and Experimental Medicine, 11(9), pp.9811~9818 (2018)
- Serpa LF, "Validity of the Braden Nutrition Subscale in predicting pressure ulcer development", Journal of Wound Ostomy & Continence Nursing, 41(5), pp.436~443 (2014)[DOI]