Prolonged stay in the emergency department is an independent risk factor for hospital‐acquired pressure ulcer

International Wound Journal - Tập 17 Số 2 - Trang 259-267 - 2020
Dong Kwan Han1, Bora Kang2, Joonghee Kim1, You Hwan Jo1, Jae Hyuk Lee1, Ji Eun Hwang1, Inwon Park1, Dong‐Hyun Jang1
1Department of Emergency Medicine, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea
2Department of Nursing, Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, Republic of Korea

Tóm tắt

AbstractIt is not easy to ensure optimal prevention of hospital‐acquired pressure ulcer (HAPU) in crowded emergency departments (EDs). We hypothesised that a prolonged ED length of stay (LOS) is associated with an increased risk of HAPU. This is a single‐centre observational study. Prospectively collected HAPU surveillance data were analysed. Adult (aged ≥20 years) patients admitted through the ED from April 1, 2013 to December 31, 2016 were included. The primary outcome was the development of HAPU within a month. Covariates included demographics, comorbidities, conditions at triage, initial laboratory results, primary ED diagnosis, critical ED interventions, and ED dispositions. The association between ED LOS and HAPU was modelled using logistic and extended Cox regression. A total of 48 641 admissions were analysed. The crude odds ratio (OR) and hazard ratio (HR) for HAPU were increased to 1.44 (95% CI, 1.20‐1.72) and 1.21 (95% CI, 1.02‐1.45), respectively, in ED LOS ≥24 hours relative to ED LOS <6 hours. In multivariable logistic regression, ED LOS ≥12 and ≥24 hours were associated with higher risk of HAPU, with ORs of 1.30 (95% CI, 1.05‐1.60) and 1.80 (95% CI, 1.45‐2.23) relative to ED LOS <6 hours, respectively. The extended Cox regression showed that the risk lasted up to a week, with HRs of 1.42 (95% CI, 1.07‐1.88) and 1.92 (95% CI, 1.44‐2.57) relative to ED LOS <6 hours, respectively. In conclusion, Prolonged ED LOS is independently associated with HAPU. Shorter ED LOS should be pursued as a goal in a multifaceted solution for HAPU.

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International Wound Journal

Tập 17 Số 2

259-267

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