scholarly journals Risk Factors for Pressure Injuries in Adult Patients: A Narrative Synthesis

Author(s):  
Man-Long Chung ◽  
Manuel Widdel ◽  
Julian Kirchhoff ◽  
Julia Sellin ◽  
Mohieddine Jelali ◽  
...  

Pressure injuries remain a serious health complication for patients and nursing staff. Evidence from the past decade has not been analysed through narrative synthesis yet. PubMed, Embase, CINAHL Complete, Web of Science, Cochrane Library, and other reviews/sources were screened. Risk of bias was evaluated using a slightly modified QUIPS tool. Risk factor domains were used to assign (non)statistically independent risk factors. Hence, 67 studies with 679,660 patients were included. In low to moderate risk of bias studies, non-blanchable erythema reliably predicted pressure injury stage 2. Factors influencing mechanical boundary conditions, e.g., higher interface pressure or BMI < 18.5, as well as factors affecting interindividual susceptibility (male sex, older age, anemia, hypoalbuminemia, diabetes, hypotension, low physical activity, existing pressure injuries) and treatment-related aspects, such as length of stay in intensive care units, were identified as possible risk factors for pressure injury development. Health care professionals’ evidence-based knowledge of above-mentioned risk factors is vital to ensure optimal prevention and/or treatment. Openly accessible risk factors, e.g., sex, age, BMI, pre-existing diabetes, and non-blanchable erythema, can serve as yellow flags for pressure injury development. Close communication concerning further risk factors, e.g., anemia, hypoalbuminemia, or low physical activity, may optimize prevention and/or treatment. Further high-quality evidence is warranted.

2018 ◽  
Vol 11 (12) ◽  
pp. 912-917 ◽  
Author(s):  
Ali Ciftci ◽  
Seval Izdes ◽  
Neriman Defne Altintas

Introduction: We aimed to determine risk factors for nephrotoxicity and factors affecting mortality in patients who received colistin. Methodology: Critical patients who received colistin were enrolled. Pregnancy, age < 18 years, basal creatinine level > 2 mg/dL, colistin use for < 48 hours, and previous renal replacement therapy were exclusion criteria. KDIGO stages were determined according to creatinine levels. Patients were grouped as those with no acute kidney injury (Group N0) and those with acute kidney injury (Group N). Their demographic data, APACHE II and SOFA scores, treatments, and laboratory results were recorded. Results: A total of 91 patients were included: 27 in Group N0 and 64 in Group N. Demographic data were similar between groups; however, higher admission APACHE-II scores (OR:1.179, 95% CI:1.033-1.346, p = 0.015) and need for vasopressors (OR:5.486, 95% CI:1.522–19.769, p = 0.009) were found to be independent risk factors for nephrotoxicity. Higher APACHE II scores (OR:1.253, %95 CI:1.093-1.437, p = 0.001), presence of coronary artery disease (OR:7.720, % 95 CI: 1.613-36.956, p = 0.011), need for vasopressors (OR: 4.587, % 95 CI: 1.224 – 17.241, p = 0.024), hypoalbuminemia (OR: 4.721, % 95 CI: 1.088 – 20.469, p = 0.038), and higher direct bilirubin levels (OR: 1.806, % 95 CI: 1.055 – 3.092, p = 0.031) were independent risk factors for mortality. Conclusion: When use of colistin is considered in ICU patients, presence of modifiable risk factors for nephrotoxicity such as hypoalbuminemia, nephrotoxic drug administration, and presence of shock should be determined and managed to prevent nephrotoxicity.


2020 ◽  
Author(s):  
Zhongzhong Liu ◽  
Wenjuan Lin ◽  
Qingli Lu ◽  
Jing Wang ◽  
Pei Liu ◽  
...  

Abstract Background: The incidences of stroke recurrence, disability, and all-cause death of patients with minor ischemic stroke (MIS) remain problematic. The aim of the present was to identify risk factors associated with adverse outcomes at 1-year after MIS in the Xi’an region of China. Methods: The cohort of this prospective cohort study included MIS patients aged 18–97 years with a National Institutes of Health Stroke Scale (NIHSS) score of ≤ 3 who were treated in any of four hospitals in Xi’an region of China between January and December 2015. The 1-year percentage of stroke recurrence, disability, and all-cause death were evaluated. Multivariate logistic regression analysis was performed to assess the association between the identified risk factors and clinical outcomes. Results: Among the 1,121 patients included for analysis, the percentage of stroke recurrence, disability, and all-cause death at 1 year after MIS were 3.4% (38/1121), 9.3% (104/1121), and 3.3% (37/1121), respectively. Multivariate logistic regression analysis identified age, current smoking, and pneumonia as independent risk factors for stroke recurrence. Age, pneumonia, and alkaline phosphatase were independent risk factors for all-cause death. Independent risk factors for disability were age, pneumonia, NIHSS score on admission, and leukocyte count. Conclusions: The 1-year outcomes of MIS is not optimistic in the Xi’an region of China, especially high percentage of disability. In this study, we found the risk factors affecting 1-year stroke recurrence, disability and, all-cause death which need further verification in the subsequent studies.


2012 ◽  
Vol 26 (3) ◽  
pp. 178 ◽  
Author(s):  
Yu Seun Kim ◽  
Soon Il Kim ◽  
Myoung Soo Kim ◽  
Kyu Ha Huh ◽  
Man Ki Ju ◽  
...  

Author(s):  
Tugba Arslan Gülen ◽  
Ayfer Imre ◽  
Uner Kayabas

Introduction: The population is aging and older adults comprise the majority of patients in intensive care units. Colistin (COL) has been reintroduced to treat increasingly common resistant Gram-negative bacterial infections. Our study aims to investigate the factors affecting colistin nephrotoxicity in the general population and geriatric age group. Materials and Method: This retrospective study included 170 patients, 116 (68.2%) of which were in the geriatric group (age ≥65). Acute renal failure was evaluated using the RIFLE score. Firstly, factors associated with COL nephrotoxicity in the general population were investigated. Then, risk factors for COL nephrotoxicity were evaluated in the geriatric patient group. Results: Advanced age (odds ratio [OR]=1.043; 95% confidence interval [CI]: 1.018-1.068; p=0.001) and initial serum creatinine level (OR=23.122; 95% CI: 3.123-171.217; p=0.002) were found to be independent risk factors associated with nephrotoxicity. In the evaluation of the geriatric population-based on nephrotoxicity, the initial serum urea and creatinine levels, immunosuppression, and overall mortality rates were found to be statistically significant in the group with nephrotoxicity (p<0.05). Initial serum creatinine level (OR=22.48; 95% CI: 2.835-178.426; p=0.003) and concomitant nephrotoxic agent use (OR=2.516; 95% CI: 1.275-4.963; p=0.008) were independent risk factors associated with nephrotoxicity in geriatric patients. Conclusion: Advanced age was found to be a risk factor for COL nephrotoxicity. Caution should be exercised especially in geriatric patients who have initial serum creatinine levels close to the upper limit, concomitant use of nephrotoxic drugs should be avoided and if possible, evaluation should be made in terms of non-COL treatment options in these patients.


2021 ◽  
Vol 13 (1) ◽  
pp. e2021060
Author(s):  
Yan Liu ◽  
Beichen Cui ◽  
Chunmei Pi ◽  
Xiaohong Yu ◽  
Zhiwei Liu ◽  
...  

Objective: This study intends to investigate the prognostic risk factors of bloodstream infection in Beijing. Methods: This study is a clinical retrospective study. Patients with community-onset bloodstream infections (COBSI) who were admitted to the emergency department and inpatient department of Beijing Jishuitan Hospital from January 1,2015 to December 31,2019 were selected as the main research objects. According to whether the patient survives for 100 days or not, the patients are divided into survival group and death group. By analyzing the clinical data of the two groups of patients, the epidemiology, clinical characteristics, bacterial resistance and risk factors affecting the prognosis of the patients were analyzed. Results: A total of 446 patients with COBSI diagnosed by blood culture were included in this study, including 252 men and 194 women. According to 100-day survival or not, patients were divided into survival group and death group, of which 363 cases were in the survival group and 83 cases were in the death group. The results of this study show that solid tumors, combined septic shock, indwelling catheters and hemodialysis treatment are independent risk factors affecting the prognosis of COBSI patients. Reasonable initial antibiotic therapy is a protective factor affecting the prognosis of COBSI patients. Conclusion: Solid tumors, combined septic shock, indwelling catheters, hemodialysis treatment, Charlson score, APACHE II score and PITT score are independent risk factors affecting the prognosis of COBSI patients in Beijing, the capital of China, and reasonable initial antibiotic therapy is a protective factor affecting the prognosis of COBSI patients.


Author(s):  
Yu. P. Potekhina ◽  
A. A. Kurnikova ◽  
D. R. Dautov ◽  
A. D. Postnikova ◽  
K. E. Novgorodskij

The review aims to systematize the main factors affecting the joint mobility. These factors can be divided into anatomical and functional, normal and pathological. Various anatomical elements of the joint and periarticular tissues serve as restraints of movement in the joint. Muscles are the main restraints. Under the infl uence of physical loads related to sports or profession, joints can undergo functional and structural changes that increase or decrease their mobility. With age, mobility in the joints decreases and degenerative diseases can develop. Risk factors for osteoarthrosis can be unchangeable (gender, age, heredity, history of trauma) and changeable (body weight, level of physical activity). By infl uencing changeable factors, it is possible to prevent and treat degenerative joint lesions.


2021 ◽  
Vol 11 ◽  
Author(s):  
Alejandro López-Valenciano ◽  
David Suárez-Iglesias ◽  
Miguel A. Sanchez-Lastra ◽  
Carlos Ayán

Purpose: This systematic review aimed to analyze the impact that the COVID-19 lockdown had on the amount of physical activity performed by university students.Materials and Methods: A systematic electronic search for studies providing information regarding physical activity levels pre and during COVID-19 pandemic in university students was performed up to 20th October 2020 in the databases Cochrane Library, PubMed, SPORTDiscus, and Web of Science. The risk of bias of external validity quality of included studies was assessed by means of those the Newcastle-Ottawa Scale (NOS). The quality of the evidence for main outcomes was graded using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.Results and Conclusions: A total of 10 studies were selected. Physical activity levels were assessed by means of questionnaires (10 studies) and accelerometer (1 study). Risk of bias was regarded as low and high in six and four investigations, respectively. The quality of evidence was downgraded to low. A significant reduction of physical activity levels were observed in 9 studies. Compared to pre-lockdown values, five studies showed a reduction of light/mild physical activity (walking) between 32.5 and 365.5%, while seven studies revealed a reduction of high/vigorous physical activity between 2.9 and 52.8%. Walking, moderate, vigorous, and total physical activity levels have been reduced during the COVID-19 pandemic confinements in university students of different countries. Despite of the reductions, those who met the current minimum PA recommendations before the lockdown generally met the recommendations also during the confinements.


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