高龄长期住院病人血红蛋白水平对医院内获得性压疮发生的影响

Effect of hemoglobin on hospital acquired pressure ulcer in elderly long-term inpatients

目的探讨高龄长期住院病人Hb水平与医院内获得性压疮(HAPU)发生风险的相关性。方法选择南京医科大学附属老年医院2017~2021年间长期住院年龄≥80岁的病人838例,收集病人的一般资料、卧床情况、失禁情况、认知状况、Braden评分、Hb水平和压疮情况。采用单因素分析和二元Logistic回归分析病人发生HAPU的影响因素。结果838例长期住院病人中发生HAPU 78例,发生率为9.31%,主要分布于ICU、血液肿瘤科、肾内科和老年医学科病房。Mann-Whitney U检验结果显示,不同Hb水平病人的HAPU发生率差异有统计学意义(P<0.001),Hb水平由≥130 g/L下降至<100 g/L时,HAPU发生率从6.19%增长至20.63%。二元Logistic回归分析显示,卧床、低Braden评分、低Hb水平是高龄长期住院病人HAPU发生的独立危险因素。结论高龄长期住院病人的Hb水平与HAPU风险相关,需要加强对该类人群Hb水平的监测。

Objective To evaluate the association between hemoglobin(Hb)level and hospital acquired pressure ulcer(HAPU)in the elderly long-term inpatients.Methods A total of 838 elderly long-term inpatients(aged≥80 years)in Geriatric Hospital of Nanjing Medical University from 2017 to 2021 were selected.The patients’general information,the condition of stay in bed,incontinence and pressure ulcers,the status of cognition,Braden score and Hb level were collected.Single factor analysis and multivariate Logistic regression analysis were used to analyze the influencing factors of HAPU in the elderly long-term inpatients.Results Among 838 patients,78 cases presented with HAPU,with an incidence rate of 9.31%.The patients with HAPU were mainly distributed in Intensive Care Unit,Hematology Oncology Department,Nephrology Department and Geriatric Department.Mann-Whitney U test showed that the incidence rate of HAPU in the patients with different Hb level was statistically significant(P<0.001).When the level of Hb decreased from≥130 g/L to<100 g/L,the incidence rate of HAPU increased from 6.19%to 20.63%.Binary Logistic regression analysis showed that stay in bed,low Braden score and low Hb level were the independent risk factors for HAPU in the elderly long-term inpatients.Conclusions The Hb level of elderly long-term inpatients is associated with the risk of HAPU,so it is necessary to monitor the level of Hb in these patients.