Perioperative factors associated with pressure ulcer development after major surgery
10.4097/kjae.2018.71.1.48
- Author:
Jeong Min KIM
1
;
Hyunjeong LEE
;
Taehoon HA
;
Sungwon NA
Author Information
1. Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea. nswksj@yuhs.ac
- Publication Type:Original Article
- Keywords:
Albumin;
Lactate;
Perioperative risk factors;
Pressure ulcer
- MeSH:
Case-Control Studies;
Comorbidity;
Critical Care;
Erythrocytes;
Humans;
Lactic Acid;
Logistic Models;
Perioperative Care;
Pressure Ulcer;
Retrospective Studies;
Risk Factors;
ROC Curve;
Ventilators, Mechanical
- From:Korean Journal of Anesthesiology
2018;71(1):48-56
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Postoperative pressure ulcers are important indicators of perioperative care quality, and are serious and expensive complications during critical care. This study aimed to identify perioperative risk factors for postoperative pressure ulcers. METHODS: This retrospective case-control study evaluated 2,498 patients who underwent major surgery. Forty-three patients developed postoperative pressure ulcers and were matched to 86 control patients based on age, sex, surgery, and comorbidities. RESULTS: The pressure ulcer group had lower baseline hemoglobin and albumin levels, compared to the control group. The pressure ulcer group also had higher values for lactate levels, blood loss, and number of packed red blood cell (pRBC) units. Univariate analysis revealed that pressure ulcer development was associated with preoperative hemoglobin levels, albumin levels, lactate levels, intraoperative blood loss, number of pRBC units, Acute Physiologic and Chronic Health Evaluation II score, Braden scale score, postoperative ventilator care, and patient restraint. In the multiple logistic regression analysis, only preoperative low albumin levels (odds ratio [OR]: 0.21, 95% CI: 0.05–0.82; P < 0.05) and high lactate levels (OR: 1.70, 95% CI: 1.07–2.71; P < 0.05) were independently associated with pressure ulcer development. A receiver operating characteristic curve was used to assess the predictive power of the logistic regression model, and the area under the curve was 0.88 (95% CI: 0.79–0.97; P < 0.001). CONCLUSIONS: The present study revealed that preoperative low albumin levels and high lactate levels were significantly associated with pressure ulcer development after surgery.
