Original Article

Analysis of Occurrence Characteristics and Influencing Factors of out-of-Hospital Induced Stress Injury in Patients with Community-Acquired Pneumonia in Respiratory Intensive Care Unit

Abstract

Background: We aimed to evaluate the characteristics of a stress injury in community-acquired pneumonia (CAP) patients in the respiratory intensive care unit (RICU) and analyze the risk factors, to provide evidence for clinical prevention and treatment.

Methods: This retrospective study was conducted in RICU at Qilu Hospital of Shandong University, China. We selected 85 patients with traumatic CAP who were brought in from January 2019 to December 2020 as the case group and 167 patients without traumatic CAP hospitalized in the same period as the control group. Multivariate binary Logistic regression analysis was used to explore the influencing factors.

Results: The incidence rate of a stress injury in 252 patients was 33.73%. The most affected region found in these patients was the sacrococcygeal region (24.26%). Most of the patients were presented in stage one (49.50%). Factors associated with a stress-induced injury in RICU, CAP patients were CURB-65 combined with cerebrovascular disease, fever combined with heart disease and albumin was found as an independent risk factor.

Conclusion: Attempts to improve stress injury in CAP patients through setting measurable process of care standards are to be encouraged. An approach including the patient’s clothes and bedding should be changed frequently, nutrition should be managed and the skin of the patient should be kept clean and dry. The occurrence of stress can further be reduced by the use of protective tools and the timely participation of the family members in patient management.

1. Labeau SO, Afonso E, Benbenishty J, et al (2021). Prevalence, associated factors and outcomes of pressure injuries in adult in-tensive care unit patients: the DecubICUs study. Intensive Care Med, 47(2): 160-169.
2. Bueno de Camargo WH, Pereira RC, et al (2018). The Effect of Support Surfaces on the Incidence of Pressure Injuries in Critically Ill Patients: A Randomized Clin-ical Trial. Crit Care Res Pract, 2018: 3712067.
3. Harvey MG, Cave G (2011). Influence of tissue pressure on central venous pres-sure/peripheral venous pressure correla-tion: An experimental report. World J Emerg Med, 2(2): 93-98.
4. Di Lecce V, Carpagnano GE, Pierucci P, et al (2020). Baseline characteristics and out-comes of COVID-19 patients admitted to a Respiratory Intensive Care Unit (RICU) in Southern Italy. Multidiscip Respir Med, 15(1): 704
5. Citty SW, Cowan LJ, Wingfield Z, Stechmil-ler J (2019). Optimizing Nutrition Care for Pressure Injuries in Hospitalized Pa-tients. Adv Wound Care (New Rochelle), 8(7): 309-322.
6. Alderden J, Drake KP, Wilson A, Dimas J, Cummins MR, Yap TL (2021). Hospital acquired pressure injury prediction in sur-gical critical care patients. BMC Med Inform Decis Mak, 21(1): 12.
7. Zhang ZX, Yong Y, Tan WC, Shen L, Ng HS, Fong KY (2018). Prognostic factors for mortality due to pneumonia among adults from different age groups in Sin-gapore and mortality predictions based on PSI and CURB-65. Singapore Med J, 59(4): 190-198.
8. Ebi WE, Hirko GF, Mijena DA (2019). Nurses' knowledge to pressure ulcer pre-vention in public hospitals in Wollega: a cross-sectional study design. BMC Nurs, 18: 20.
9. García-Sánchez FJ, Martínez-Vizcaíno V, Rodríguez-Martín B (2019). Patients' and Caregivers' Conceptualisations of Pres-sure Ulcers and the Process of Decision-Making in the Context of Home Care. Int J Environ Res Public Health, 16(15): 2719.
10. Zuercher P, Moret CS, Dziewas R, Schefold JC (2019). Dysphagia in the intensive care unit: epidemiology, mechanisms, and clinical management. Crit Care, 23(1): 103.
11. Wolak M, Bojanowska E, Staszewska T, Piera L, Szymański J, Drobnik J (2021). Histamine augments collagen content via H1 receptor stimulation in cultures of myofibroblasts taken from wound granu-lation tissue. Mol Cell Biochem, 476(2): 1083-1092.
12. Sullivan SC, Bopp MM, Weaver DL, Sullivan DH (2016). Innovations in Calculating Precise Nutrient Intake of Hospitalized Patients. Nutrients, 8(7): 412.
13. Jiang Q, Li X, Qu X, et al (2014). The inci-dence, risk factors and characteristics of pressure ulcers in hospitalized patients in China. Int J Clin Exp Pathol, 7(5): 2587-2594.
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IssueVol 51 No 3 (2022) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijph.v51i3.8932
Keywords
Community-acquired pneumonia Stress injury Risk factors Site Staging

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How to Cite
1.
Zhang C, Ma J, Hao J. Analysis of Occurrence Characteristics and Influencing Factors of out-of-Hospital Induced Stress Injury in Patients with Community-Acquired Pneumonia in Respiratory Intensive Care Unit. Iran J Public Health. 2022;51(3):562-568.