eISSN 2097-6046
ISSN 2096-7446
CN 10-1655/R
Responsible Institution:China Association for Science and Technology
Sponsor:Chinese Nursing Association
Research Paper

The status and risk factors analysis of acute skin failure in critically ill elderly patients

  • XU Pei ,
  • WU Lingyu ,
  • MA Lihua ,
  • XU Xiaowen ,
  • ZHOU Jinhong
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  • EICU,Suzhou Municipal Hospital,Suzhou, 215000,China

Received date: 2023-06-24

  Online published: 2024-05-14

Abstract

Objective To investigate the incidence and risk factors of acute skin failure in critically ill elderly patients. Methods A prospective observational study was carried out in elderly patients admitted to EICU in a tertiary grade A hospital in Suzhou from January 2021 to January 2023,the risk factors of acute skin failure were analyzed by univariate and multivariate Logistic regression. Results 251 elderly patients completed the survey,105 cases had acute skin failure,the incidence was 41.83%. Logistic regression analysis showed that the risk factors of acute skin failure in severe elderly patients included Braden score(OR=0.732),renal failure(OR=2.881),heart failure(OR=3.962),sepsis(OR=2.459),arterial blood lactic acid level(OR=1.226),sedation and analgesia(OR=3.135). Conclusion The incidence of acute skin failure in critically ill elderly patients is high. Low Braden score,renal failure,heart failure,sepsis,and high arterial blood lactic acid level,use of sedatives and analgesics were independent risk factors for acute skin failure in critically ill elderly patients.

Cite this article

XU Pei , WU Lingyu , MA Lihua , XU Xiaowen , ZHOU Jinhong . The status and risk factors analysis of acute skin failure in critically ill elderly patients[J]. Chinese Journal of Emergency and Critical Care Nursing, 2024 , 5(5) : 401 -407 . DOI: 10.3761/j.issn.2096-7446.2024.05.003

References

[1] Langemo DK,Brown G.Skin fails too:acute,chronic,and end-stage skin failure[J]. Adv Skin Wound Care,2006,19(4):206-211.
[2] 金琇泽,路云. 中国老年人共病状况及其对医疗卫生支出的影响研究[J]. 中国全科医学,2019,22(34):4166-4172.
Jin XZ,Lu Y.Prevalence of comorbidity among the elderly and its impact on healthcare expenditure in China[J]. Chin Gen Pract,2019,22(34):4166-4172.
[3] Parnham A,Copson D,Loban T.Moisture-associated skin damage:causes and an overview of assessment,classification and management[J]. Br J Nurs,2020,29(12):S30-S37.
[4] Kim JH,Shin HK,Jung GY,et al.A case of acute skin failure misdiagnosed as a pressure ulcer,leading to a legal dispute[J]. Arch Plast Surg,2019,46(1):75-78.
[5] Delmore B,Cox J,Smith D,et al.Acute skin failure in the critical care patient[J]. Adv Skin Wound Care,2020,33(4):192-201.
[6] Cohen KE,Scanlon MC,Bemanian A,et al.Pediatric skin failure[J]. Am J Crit Care,2017,26(4):320-328.
[7] 急诊危重症患者院内转运共识专家组. 急诊危重症患者院内转运共识:标准化分级转运方案[J]. 中华急诊医学杂志,2017,26(5):512-516.
Consensus Expert Group on In-Hospital Transport of Emergency Critically Ill Patients.Consensus on hospital transport of emergency critically ill patients-standardized grading transport scheme[J]. Chin J Emerg Med,2017,26(5):512-516.
[8] Falotico JM,Shinozaki K,Saeki K,et al.Advances in the approaches using peripheral perfusion for monitoring hemodynamic status[J]. Front Med(Lausanne),2020,7:614326.
[9] Ait-Oufella H,Lemoinne S,Boelle PY,et al.Mottling score predicts survival in septic shock[J]. Intensive Care Med,2011,37(5):801-807.
[10] Ferraris A,Bouisse C,Mottard N,et al.Mottling score and skin temperature in septic shock:relation and impact on prognosis in ICU[J]. PLoS One,2018,13(8):e0202329.
[11] 王淑娟,刘志梅,荆晨晨,等. 危重症病人动脉血乳酸与急性皮肤衰竭的相关性研究[J]. 护理研究,2022,36(24):4343-4350.
Wang SJ,Liu ZM,Jing CC,et al.Correlation between arterial blood lactic acid and acute skin failure in critically ill patients[J]. Chin Nurs Res,2022,36(24):4343-4350.
[12] Mileski M,McClay R,Natividad J. Facilitating factors in the proper identification of acute skin failure:a systematic review[J]. Crit Care Nurse,2021,41(2):36-42.
[13] 杨可娜,徐玲芬,李敏,等. ICU护士对急性皮肤衰竭认知现状问卷的编制及信效度检验[J]. 中华急危重症护理杂志,2023,4(4):298-303.
Yang KN,Xu LF,Li M,et al.Development and psychometric testing of ICU nurses' cognition of acute skin failure questionnaire[J]. Chin J Emerg Crit Care Nurs,2023,4(4):298-303.
[14] Pittman J,Beeson T,Dillon J,et al.Hospital-acquired pressure injuries and acute skin failure in critical care:a case-control study[J]. J Wound Ostomy Continence Nurs,2021,48(1):20-30.
[15] 陈香萍,劳月文,张奕,等. 重症患者急性皮肤衰竭的研究进展[J]. 中华护理杂志,2021,56(3):376-380.
Chen XP,Lao YW,Zhang Y,et al.Research progress of acute skin failure in critically ill patients[J]. Chin J Nurs,2021,56(3):376-380.
[16] 赵池,王明烨,崔雯雯,等. 心房利尿钠肽在心力衰竭治疗中的研究进展[J]. 心血管病学进展,2022,43(12):1109-1113.
Zhao C,Wang MY,Cui WW,et al.Atrial natriuretic peptide in treatment of heart failure[J]. Adv Cardiovasc Dis,2022,43(12):1109-1113.
[17] Koskela M,Ala-Kokko TI,Gäddnäs F,et al.Blister fluid and serum cytokine levels in severe sepsis in humans reflect skin dysfunction[J]. Acta Anaesthesiol Scand,2017,61(1):53-61.
[18] 徐好,金瑛,黄琼蕾. 急性皮肤衰竭与压力性损伤评估鉴别研究进展[J]. 护理学杂志,2022,37(3):109-112.
Xu H,Jin Y,Huang QL.Differentiation and assessment of acute skin failure and pressure injury:a literature review[J]. J Nurs Sci,2022,37(3):109-112.
[19] 张智宏,李芸,吴婷婷,等. 基于下肢皮肤花斑评分的预测模型对脓毒症患者预后的判断价值[J]. 中国实用护理杂志,2022,38(35):2729-2734.
Zhang ZH,Li Y,Wu TT,et al.Prognostic value of a predictive model based on lower limb skin mottling score in determining the prognosis of patients with sepsis[J]. Chin J Pract Nurs,2022,38(35):2729-2734.
[20] 毕安平,黄素芳,熊杰. 脓毒症休克皮肤花斑危险因素分析及护理策略[J]. 中西医结合护理(中英文),2020,6(10):17-22.
Bi AP,Huang SF,Xiong J.Analysis of risk factors of skin mottle in septic shock and nursing strategies[J]. Nurs Integr Tradit Chin West Med,2020,6(10):17-22.
[21] 毕安平,邓娟,何梅,等. 脓毒症并发皮肤衰竭的研究进展[J]. 实用医学研究,2019,1(2):28-32.
Bi AP,Deng J,He M,et al.Research progress of sepsis complicated with skin failure[J]. Prac Med Res,2019,1(2):28-32.
[22] 李维维,权明桃,闵玉娣,等. 脓毒症休克病人死亡病例分析[J]. 全科护理,2019,17(28):3549-3551.
Li WW,Quan MT,Min YD,et al.Analysis of death cases of septic shock patients[J]. Chin Gen Pract Nurs,2019,17(28):3549-3551.
[23] Curry K,Kutash M,Chambers T,et al.A prospective,descriptive study of characteristics associated with skin failure in critically ill adults[J]. Ostomy Wound Manag,2012,58(5):36-43.
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