S. Stordeur et al., THE IMPORTANCE OF REPEATED RISK ASSESSMENT FOR PRESSURE SORES IN CARDIOVASCULAR-SURGERY, Journal of Cardiovascular Surgery, 39(3), 1998, pp. 343-349
Background Patients undergoing cardiovascular surgery are at high risk
for sores because of impaired perfusion, the time spent on the operat
ing room table, and restricted mobility in the immediate postoperative
period. Objective. To identify risk factors for sores. Methods. In a
900-bed teaching hospital, 163 patients who underwent cardiovascular i
nterventions were enrolled. Risk measurement included skin assessment,
Braden and Norton scales, physic and biologic data and specific risk
factors. The development of the most severe stages of pressure sores w
as followed (Stages II and III). Results. Forty-eight (29.5%) patients
totalized 75 pressure sores. In univariate analyses, Norton and Brade
n scores, hemoglobin concentration, presence of ulcers at admission, u
se of antihypertensive drugs, systemic use of corticosteroids, nosocom
ial infection, re-intervention and readmission in intensive care units
were associated with sores. In a logistic regression model, hemoglobi
n concentration at admission (p=0.0007), postoperative Braden score (p
=0.0002), and postoperative steroid therapy (p=0.020) were the only pr
edictors of sores. Total length of stay was 6 days higher (p=0.03) for
patients with pressure sores. Conclusions. The detection of risks is
recommended during the entire stay. Identification of patients at risk
is required to provide preventive resources appropriately, which can
lessen the incidence of pressure sores and reduce patient discomfort,
length and costs of hospital stay.