Predictors of Intraoperative Pressure Injury in Patients Undergoing Major Hepatobiliary Surgery

作者：Yan Chen, Li He, Wei Qu, Chen Zhang · 发表于：Journal of Wound Ostomy and Continence Nursing · 年份：2017 · DOI：10.1097/won.0000000000000356 · 被引用次数：39 · 研究领域：Pressure Ulcer Prevention and Management、Enhanced Recovery After Surgery、Abdominal Surgery and Complications

PURPOSE: The purpose of this study was to identify risk factors associated with pressure injury (PI) development in patients undergoing major hepatobiliary surgery requiring general anesthesia. DESIGN: Retrospective medical review and analysis. SUBJECTS AND SETTING: Medical records from 803 patients undergoing hepatobiliary surgery from October 2015 to October 2016 were reviewed. The study setting was a 3400-bed military academic medical center in the northeast region of China. METHODS: Demographic variables, comorbid conditions, preoperative Braden Scale for Pressure Sore Risk scores, preoperative serum hemoglobin and albumin levels, type of surgery, positioning, surgical time, hypotensive episodes, blood loss, body temperature, and other potential risk factors for PI development were collected. Pressure injury occurrences during a 48-hour period after surgery were recorded along with stage. Data were analyzed using univariate analyses and multivariate logistic regression analysis to build a predictive model for factors associated with PI occurrences. RESULTS: The prevalence of PIs in major hepatobiliary surgery patients was 19.8%, 4.9%, and 4.1% in the immediate postoperative period, on the first day and the second day after surgery, respectively. Pancreaticoduodenectomy surgery (odds ratio [OR]: 3.957, 95% confidence interval [CI]: 2.145-7.302, P < .001), open surgery (OR: 2.917, 95% CI: 1.558-5.463, P = .001), surgical time (cutoff point at 197 minutes for increased risk ...