Evidence map›Paper›PMID 33034686›Full record

ArticleIntensive care medicine2021

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study.

Sonia O Labeau, Elsa Afonso, Julie Benbenishty, Bronagh Blackwood, Carole Boulanger, Stephen J Brett, Silvia Calvino-Gunther, Wendy Chaboyer, Fiona Coyer, Mieke Deschepper and 13 more

Erratum issued 2 registry-linked trialsOpen access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Intensive care medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 2 registered trials, which are not on this map. Cited by 112 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
112citing papers in PubMed, 7 pooled it
73.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05124197 completednot on this map

Safety and Efficacy of a Strategy Extending Duration of Prone Position in COVID-19-related ARDS Patients. a Retrospective Monocentric Observational Study

TypeobservationalSponsorHôpital Louis MourierRan2020 to 2021Enrolled81ConditionsPressure Ulcer, Respiratory Distress Syndrome, Acute, Hypoxemic Respiratory Failure, COVID-19 Acute Respiratory Distress SyndromeArmsprone position
NCT05894291 nacompletednot on this mapstarted 2023, after this paper: background citation

Evaluation Two Different Prone Position Techniques on the Occurrence of Pressure Sores in Patients With Invasive Mechanical Ventilation With Acute Respiratory Distress Syndrome in the Intensive Care Unit : a Multicenter, Prospective Randomized Controlled Trial.

TypeinterventionalSponsorUniversity Hospital, ToursRan2023 to 2025Enrolled334ConditionsAcute Respiratory Distress Syndrome, Pressure Ulcers Stage IIIArmsSwimmer Prone Position, Prone position with arms alongside the body
3 · Its place in the literature

Who cites it

112 citing papers in PubMed, 7 syntheses or guidelines pooled it, 320 citations in OpenAlex.

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  7. A systematic review of clinical practice guidelines and other best practice recommendations for pressure injury risk assessment in the United States.Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society
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52 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

23 authors at 20 institutions in 11 countries.

Sonia O LabeauNursing Department, Faculty of Education, Health and Social Work, HOGENT University of Applied Sciences and Arts, Ghent, Belgium.ORCID http://orcid.org/0000-0003-3863-612X
Elsa AfonsoDepartment of Internal Medicine, Faculty of Medicine and Health Science, Ghent University, C. Heymanslaan 10, 9000, Ghent, Belgium.ORCID http://orcid.org/0000-0003-0873-0852
Julie BenbenishtyHadassah Hebrew University Medical Center, Jerusalem, Israel.ORCID http://orcid.org/0000-0002-8488-9649
Bronagh BlackwoodWellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland, UK.ORCID http://orcid.org/0000-0002-4583-5381
Carole BoulangerIntensive Care Department, Royal Devon and Exeter NHS Foundation Trust, Exeter, Devon, UK.ORCID http://orcid.org/0000-0002-1392-6633
Stephen J BrettSection of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Imperial College London, London, UK.ORCID http://orcid.org/0000-0003-4545-8413
Silvia Calvino-GuntherMedical Intensive Care Unit, University Hospital of Grenoble-Alpes, Grenoble, France.ORCID http://orcid.org/0000-0003-3586-7205
Wendy ChaboyerMenzies Health Institute Queensland, School of Nursing and Midwifery, Griffith University, Brisbane, Australia.ORCID http://orcid.org/0000-0001-9528-7814
Fiona CoyerSchool of Nursing, Royal Brisbane and Women's Hospital, Queensland University of Technology and Intensive Care Services (ICS), Herston, Australia.ORCID http://orcid.org/0000-0002-8467-0081
Mieke DeschepperStrategic Policy Cell, Ghent University Hospital, Ghent, Belgium.ORCID http://orcid.org/0000-0001-6797-3147
Guy FrançoisDivision of Scientific Affairs-Research, European Society of Intensive Care Medicine, Brussels, Belgium.
Patrick M HonoreIntensive Care Department, CHU Brugmann University Hospital, Brussels, Belgium.ORCID http://orcid.org/0000-0002-6697-4890
Radmilo JankovicDepartment for Anesthesia and Intensive Care, School of Medicine, University of Nis, Niš, Serbia.ORCID http://orcid.org/0000-0003-0742-8686
Ashish K KhannaSection on Critical Care Medicine, Department of Anesthesiology, Critical Illness, Injury Recovery and Research Center, Wake Forest School of Medicine, Winston-Salem, NC, USA.ORCID http://orcid.org/0000-0002-9083-891X
Mireia Llaurado-SerraNursing Department, Universitat Internacional de Catalunya, Barcelona, Spain.ORCID http://orcid.org/0000-0002-5123-0581
Frances LinMenzies Health Institute Queensland, School of Nursing and Midwifery, Griffith University, Brisbane, Australia.ORCID http://orcid.org/0000-0001-8735-5469
Louise RoseFlorence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.ORCID http://orcid.org/0000-0003-1700-3972
Francesca RubulottaSection of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Imperial College London, London, UK.ORCID http://orcid.org/0000-0001-8644-1728
Leif SaagerKlinik für Anaesthesiologie, Universitaetsmedizin Goettingen, Göttingen, Germany.ORCID http://orcid.org/0000-0003-3416-4727
Ged WilliamsAl Mafraq Hospital, Abu Dhabi, United Arab Emirates.ORCID http://orcid.org/0000-0002-7481-2445
Stijn I BlotNursing Department, Faculty of Education, Health and Social Work, HOGENT University of Applied Sciences and Arts, Ghent, Belgium. stijn.blot@UGent.be.ORCID http://orcid.org/0000-0003-2145-0345
DecubICUs Study Team
European Society of Intensive Care Medicine (ESICM) Trials Group Collaborators
Griffith University · AUOutcomes Research Consortium · USUniversity of Michigan · USCentre Hospitalier Universitaire Brugmann · BEHadassah Medical Center · ILImperial College London · GBCentre Hospitalier Universitaire de Grenoble · FRUniversitat Internacional de Catalunya · ESToronto East General Hospital · CAUniversity of Nis · RSUniversity of the Sunshine Coast · AUUniversity of Huddersfield · GBEuropean Society of Intensive Care Medicine · BERoyal Devon & Exeter NHS Foundation Trust · GBGhent University Hospital · BEUniversity of Cambridge · GBGhent University · BEKing's College London · GBUniversity College Ghent · BEQueen's University Belfast · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeIntensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients.

methodsInternational 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis.

resultsData from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9-27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6-16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score < 19, ICU stay > 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2-1.8), stage II (OR 1.6; 95% CI 1.4-1.9), and stage III or worse (OR 2.8; 95% CI 2.3-3.3).

conclusionPressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat.

Indexed as

Intensive Care UnitsPressure UlcerAdultAgedFemaleHospital MortalityHumansMalePatient DischargePrevalenceRespiration, ArtificialRisk FactorsDecubitus epidemiologyICUMorbidityMortalityOutcomePressure injuryPressure ulcerRisk factors

Identifiers

PMID33034686
PMCPMC7880913
OpenAlexW3092157901

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.