• Am. J. Crit. Care · May 2023

    Risk Factors Associated With Pressure Injury in Critically Ill Children With Congenital Heart Disease.

    • Ashlee Shields and Jiuann-Huey Ivy Lin.
    • Ashlee Shields is a programmatic nurse specialist in the cardiac intensive care unit, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania and an assistant professor, School of Nursing, Education and Human Studies, Robert Morris University, Moon Township, Pennsylvania.
    • Am. J. Crit. Care. 2023 May 1; 32 (3): 216220216-220.

    BackgroundChildren with congenital heart disease have unique risk factors associated with the pathophysiology of an abnormal heart; hence, this population is most likely at increased risk of acquiring a pressure injury during hospitalization. Few studies have included patients with congenital heart disease or examined the factors unique to these patients.ObjectiveTo identify risk factors associated with pressure injury development in children with congenital heart disease.MethodsThis retrospective study used a convenience sample from hospital-acquired data at an urban, tertiary, free-standing children's hospital. Patients were admitted to the intensive care unit between 2011 and 2018 with a diagnosis of congenital heart disease. Chi-square analysis was done to compare risk factors between patients, and logistic regression analysis was used to predict the probability that a patient would acquire a pressure injury.ResultsEighty-two (30.5%) of the 269 patients in this study acquired pressure injuries. Sixty-six patients with pressure injuries met the inclusion criteria for analysis; 82% of those patients had had corticosteroids prescribed, and 71% were receiving anticoagulants. The overall predictive model for acquiring a pressure injury indicated an odds ratio of 3.25 (95% CI, 1.58-6.65) with an anticoagulant and an odds ratio of 9.98 (95% CI, 4.68-21.3) with a prescribed corticosteroid (P < .001 for both factors). Inpatient mortality was significantly associated with pressure injuries.ConclusionsCorticosteroid and anticoagulant use were contributing factors in the development of pressure injuries in children with congenital heart disease.©2023 American Association of Critical-Care Nurses.

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