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Pressure ulcer development in trauma patients with suspected spinal injury; the influence of risk factors present in the Emergency Department

Pressure ulcer development in trauma patients with suspected spinal injury; the influence of risk factors present in the Emergency Department
Pressure ulcer development in trauma patients with suspected spinal injury; the influence of risk factors present in the Emergency Department
Objectives

To explore the influence of risk factors present at Emergency Department admission on pressure ulcer development in trauma patients with suspected spinal injury, admitted to the hospital for evaluation and treatment of acute traumatic injuries.

Design

Prospective cohort study setting level one trauma center in the Netherlands participants adult trauma patients transported to the Emergency Department on a backboard, with extrication collar and headblocks and admitted to the hospital for treatment or evaluation of their injuries.

Methods

Between January and December 2013, 254 trauma patients were included. The following dependent variables were collected: Age, Skin color and Body Mass Index, and Time in Emergency Department, Injury Severity Score, Mean Arterial Pressure, hemoglobin level, Glasgow Coma Score, and admission ward after Emergency Department.

Results

Pressure ulcer development during admission was associated with a higher age (p 0.00, OR 1.05) and a lower Glasgow Coma Scale score (p 0.00, OR 1.21) and higher Injury Severity Scores (p 0.03, OR 1.05). Extra nutrition decreases the probability of PU development during admission (p 0.04, OR 0.20). Pressure ulcer development within the first 48 h of admission was positively associated with a higher age (p 0.01, OR 1.03) and a lower Glasgow Coma Scale score (p 0.01, OR 1.16). The proportion of patients admitted to the Intensive Care Unit and Medium Care Unit was higher in patients with pressure ulcers.

Conclusions

The pressure ulcer risk during admission is high in patients with an increased age, lower Glasgow Coma Scale and higher Injury Severity Score in the Emergency Department. Pressure ulcer risk should be assessed in the Emergency Department to apply preventive interventions in time.
1755-599X
1-7
Ham, H.W.
585ca09b-13d4-4558-8947-33977ce02eba
Schoonhoven, Lisette
46a2705b-c657-409b-b9da-329d5b1b02de
Schuurmans, M.J.
0e172e47-447c-40b0-a614-2f3efacc082c
Leenen, L.P.H.
b3108bd2-2d8a-43ea-a683-8289a195d661
Ham, H.W.
585ca09b-13d4-4558-8947-33977ce02eba
Schoonhoven, Lisette
46a2705b-c657-409b-b9da-329d5b1b02de
Schuurmans, M.J.
0e172e47-447c-40b0-a614-2f3efacc082c
Leenen, L.P.H.
b3108bd2-2d8a-43ea-a683-8289a195d661

Ham, H.W., Schoonhoven, Lisette, Schuurmans, M.J. and Leenen, L.P.H. (2016) Pressure ulcer development in trauma patients with suspected spinal injury; the influence of risk factors present in the Emergency Department. International Emergency Nursing, 1-7. (doi:10.1016/j.ienj.2016.05.005). (PMID:27450044)

Record type: Article

Abstract

Objectives

To explore the influence of risk factors present at Emergency Department admission on pressure ulcer development in trauma patients with suspected spinal injury, admitted to the hospital for evaluation and treatment of acute traumatic injuries.

Design

Prospective cohort study setting level one trauma center in the Netherlands participants adult trauma patients transported to the Emergency Department on a backboard, with extrication collar and headblocks and admitted to the hospital for treatment or evaluation of their injuries.

Methods

Between January and December 2013, 254 trauma patients were included. The following dependent variables were collected: Age, Skin color and Body Mass Index, and Time in Emergency Department, Injury Severity Score, Mean Arterial Pressure, hemoglobin level, Glasgow Coma Score, and admission ward after Emergency Department.

Results

Pressure ulcer development during admission was associated with a higher age (p 0.00, OR 1.05) and a lower Glasgow Coma Scale score (p 0.00, OR 1.21) and higher Injury Severity Scores (p 0.03, OR 1.05). Extra nutrition decreases the probability of PU development during admission (p 0.04, OR 0.20). Pressure ulcer development within the first 48 h of admission was positively associated with a higher age (p 0.01, OR 1.03) and a lower Glasgow Coma Scale score (p 0.01, OR 1.16). The proportion of patients admitted to the Intensive Care Unit and Medium Care Unit was higher in patients with pressure ulcers.

Conclusions

The pressure ulcer risk during admission is high in patients with an increased age, lower Glasgow Coma Scale and higher Injury Severity Score in the Emergency Department. Pressure ulcer risk should be assessed in the Emergency Department to apply preventive interventions in time.

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More information

Accepted/In Press date: 2 May 2016
e-pub ahead of print date: 19 July 2016
Organisations: Faculty of Health Sciences

Identifiers

Local EPrints ID: 402165
URI: http://eprints.soton.ac.uk/id/eprint/402165
ISSN: 1755-599X
PURE UUID: 9025410b-237c-432b-ae0b-b30f7f5dfa6d
ORCID for Lisette Schoonhoven: ORCID iD orcid.org/0000-0002-7129-3766

Catalogue record

Date deposited: 31 Oct 2016 16:36
Last modified: 15 Mar 2024 06:01

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Contributors

Author: H.W. Ham
Author: M.J. Schuurmans
Author: L.P.H. Leenen

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