Purpose: The aim of this study was to identify factors affecting pressure ulcers among cognitive impairment inpatients with long term care facilities. Methods: In this secondary data analysis of the two long-term care facilities, 162 patients with mild or more cognitive impairment were analyzed. Patients with a pressure ulcer of stage 2 or higher that developed after the first day of hospitalization were defined as the pressure ulcer group, while the other patients comprised the non-pressure ulcer group. Demographic characteristics were compared between the two groups. Initially, a univariate analysis was conducted. Subsequently, risk factors were identified through logistic regression analysis using the variables that exhibited statistically significant differences in the univariate analysis. Results: Thirty-three patients had hospital-acquired pressure ulcers. Age (odds ratio [OR]=0.92, 95% confidence interval [CI]=0.87~0.98), albumin levels (OR=0.25, 95% CI=0.08~0.77), Charlson comorbidity index (OR=1.57, 95% CI=1.14~2.18), and Mini-Mental State Examination for Koreans score (OR=0.90, 95% CI=0.81~0.99) were identified as risk factors for pressure ulcer occurrence. Conclusion Our data analysis supports independent associations between certain clinical characteristics and pressure ulcer occurrence in long-term care facility patients with cognitive impairment. To reduce the risk of pressure ulcers in long-term care facilities, health professionals should implement appropriate prevention measures.

OBJECTIVES: Obstructive sleep apnea syndrome (OSAS) has drawn increasing attention as medical community has become to be aware of its co-morbidities and complications, especially cardiovascular complications and excessive daytime sleepiness with accident proneness. As of now, polysomnography is the standard tool to diagnose sleep apnea and estimate the treatment validity. However, its being rather expensive and inconvenient, alternate diagnostic tools have been proposed including wrist actigraphy. So far, actigraphies have been adopted usefully to field-survey sleep apnea prevalence. In this study, we attempted in a sleep laboratory setting to assess the supplemental value of actigraphy in diagnosing OSAS. METHODS: This study was done at the Division of Sleep Studies, the Seoul National University Hospital. Thirty-seven clinically suspected cases of OSAS underwent the one-night polysomnography, simultaneously wearing an actigraphy on non-dominant wrist. We analyzed the data of 27 polysomnographically-proven OSAS patients (male: female 20: 7; age 47.6+/-12.9 years old; age range 23 to 72 years) with no other sleep disorders. We calculated RDI (respiratory disturbance index) from the polysomnography data and FI (fragmentation index) from the actigraphy data. Pearson correlation was calculated in order to compare FI with RDI and to evaluate the supplemental diagnostic value of the actigraphy. RESULTS: Mean total sleep time on polysomnography was 401.4+/-57.8 min (range of 274.0 to 514.1 min). Mean RDI was 21.7+/-20.4 /hour. Mean FI was 21.9+/-13.0 / hour. RDI and FI showed significant correlation (r=0.55, p< 0.01). CONCLUSIONS: Wrist actigraphy in OSAS patients generates a comparable outcome to polysomnography, in measuring the nocturnal sleep fragmentation. The actigraphy could be used supplementally in inpatients, outpatients, and field survey subjects, if polysomnography is unavailable or impossible. In follow-ups related with nasal CPAP (continuous positive airway pressure), upper airway surgery, and oral appliance in OSAS patients, the actigraphy might play a more dominant role in the future.
Accident Proneness ; Actigraphy* ; Female ; Follow-Up Studies ; Humans ; Inpatients ; Outpatients ; Polysomnography ; Prevalence ; Seoul ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Sleep Deprivation ; Sleep Wake Disorders ; Wrist