医院获得性压力性损伤的发病因素分析

Study of the related factors of multiple hospital⁃acquired pressure ulcers

目的分析影响医院获得性压力性损伤(HAPU)多发的相关因素。方法收集2015年1月至2018年12月西安交通大学第一附属医院住院病人发生HAPU的基本信息及转归资料。对HAPU病人的人口学资料,发生部位、分期、转归以及是否发热等进行回顾性分析,得出HAPU的分布现状。用二分类logistic回归分析HAPU多发病人的影响因素。结果 306 618例病人中,HAPU现患率为0.054%。HAPU发生前危险初评(Braden计分)和复评均达到100%。其中167例HAPU中男性105例,女性62例,年龄(58.43±18.28)岁;住院时长(25.51±30.71)d;有65例在HAPU发生前有发热(38.7%);logistic回归结果显示:HAPU多发与所选的全部因素(年龄、性别、分期、白蛋白水平、是否高血压、是否为ICU病人、是否合并有糖尿病、是否合并肾功能不全等)均无密切关联(P>0.05)。结论年龄、性别、分期、白蛋白水平、是否高血压、是否为ICU病人、是否合并有糖尿病、是否合并肾功能不全等多个因素,均不是病人HAPU多发的影响因素。

Objective To analyze the related factors affecting the incidence of hospital⁃acquired pressure ulcers(HAPU).Meth⁃ods The basic information and outcome data of inpatients with HAPU in The First Affiliated Hospital of Xi’an Jiaotong Universi⁃ty from January 2015 to December 2018 were collected.The demographic data,location,stage,outcome and fever of patients with HAPU were retrospectively analyzed,and the distribution of HAPU was obtained.The influencing factors of multiple HAPU patients were analyzed by binomial logistic regression.Results Among the 306,618 patients,the prevalence of HAPU was 0.054%.Both the preliminary risk assessment(Braden score)before the occurrence of HAPU and reassessment reached 100%.Among the 167 cases of stress injury,105 were male and 62 were female.The average age was(58.43±18.28)years old;the average hospitalization time was(25.51±30.71)days;65 cases had fever before the occurrence of stress injury(38.7%).Logistic regression results showed that none of the selected factors(age,gender,pressure sore staging,albumin level,high blood pressure,ICU patients,diabetes,kid⁃ney function is combined)were closely related to the occurrence of HAPU(P>0.05).Conclusion Age,gender,pressure sore staging,albumin level,hypertension,ICU patients,diabetes,renal insufficiency are not the risk factors of stress⁃induced injury.