• Nele Nijs, Adinda Toppets, Tom Defloor, Kris Bernaerts, Koen Milisen, and Greet Van Den Berghe.
• Department of Intensive Care Medicine, University Hospital Gasthuisberg, Catholic University of Leuven, Leuven, Belgium.
• J Clin Nurs. 2009 May 1;18(9):1258-66.

AimsTo determine the incidence of pressure ulcers occurring at least 48 hours after admission and risk factors for pressure ulcers grade 2-4 in a long-stay surgical Intensive Care Unit (ICU) population.BackgroundThe incidence of pressure ulcers in intensive care units is larger than in non-intensive environments.DesignProspective descriptive research design.MethodsUsing pressure ulcers grade 2-4 as an outcome measure, a multivariate logistic regression analysis was used to identify the risk factors. Data were obtained on a daily basis in a surgical intensive care unit of the University Hospital Leuven between November 2003-March 2004. A total of 520 long-stay (>or= 24 hours) intensive care patients were included.ResultsCumulative incidence of pressure ulcers grade 2-4 was 20.1%. The following variables were positively associated with pressure ulcers grade 2-4: history of vascular disease, treatment with Dopamine or Dobutamine, intermittent haemodialysis (IHD) or continuous veno-venous haemofiltration (CVVH), mechanical ventilation. Also preventive measures were statistically positively associated with pressure ulcers grade 2-4: turning, floating heels, alternating mattresses, adequate prevention. The use of sedatives, body temperature above 38.5 degrees C and sitting in chair where negatively associated with pressure ulcers. Pressure ulcers are statistically associated with different risk factors and preventive measures.ConclusionThe identified risk factors are eligible to be included in a new risk assessment scale for patients admitted to intensive care units.Relevance To Clinical PracticeThe novel insights have implications for risk assessment for patients in intensive care units. Patients admitted to intensive care units have other risk factors for pressure ulcers which are eligible to be included in a new risk assessment scale.

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