Pressure injuries in elderly with acute myocardial infarction

• Published in: Clinical interventions in aging Vol. 12; pp. 1495 - 1501
• Main Authors: Komici, Klara, Vitale, Dino F, Leosco, Dario, Mancini, Angela, Corbi, Graziamaria, Bencivenga, Leonardo, Mezzani, Alessandro, Trimarco, Bruno, Morisco, Carmine, Ferrara, Nicola, Rengo, Giuseppe
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2017; Taylor & Francis Ltd; Dove Medical Press
• Subjects: acute myocardial systolic dysfunction; Age; Care and treatment; Chronic obstructive pulmonary disease; Decubitus ulcer; Diabetes; Elderly patients; Heart attack; Heart attacks; Hemoglobin; Hospitalization; Hospitals; Intensive care; Intensive care nursing; Malnutrition; Medical research; mini nutritional assessment; Norton Scale; Original Research; Patients; Pressure ulcers; Risk assessment; Risk factors; Skin; Systematic review; Variables; Italy; pressure injury; Mini Nutritional Assessment; acute myocardial systolic dysfunction; Norton Scale
• DOI: 10.2147/CIA.S135676
• ISSN: 1178-1998; 1176-9092

To assess pressure injury (PI) incidence among patients hospitalized for acute myocardial infarction (AMI) in an intensive coronary care unit (ICCU) and to detect the impact of specific risk factors on the development of PI in this clinical setting. Prospective cohort study in ICCU setting. Patients admitted for AMI: patients mean age 67.5±11.5 years (n=165). Norton Scale, Mini Nutritional Assessment (MNA), demographic, clinical and biochemical data collected at the time of ICCU admission have been tested in a logistic model to assess the odds ratios (ORs) of PI risk development. The jackknifed area under the receiver operating characteristic curve (AUC) and the decision curve analysis have been employed to assess the additive predictive value of a factor. Twenty-seven (16.3%) patients developed PIs. An increased PI risk was associated with advanced age (OR =2.5 every 10-year increase; 95% CI =1.1-5.7), while probability of PI development was reduced in patients with higher left ventricular ejection fraction (LVEF) (OR =0.4 every 5% increase; 95% CI =0.24-0.66), MNA score (OR =0.65 every unit change; 95% CI =0.44-0.95) and Norton Scale score (OR =0.7 every unit change; 95% CI =0.57-0.88). The AUC and the decision curve analysis showed that LVEF inclusion improved the discrimination power and the clinical net benefit of the final model. Age, LVEF, Norton Scale and MNA scores have a strong and independent clinical value as predictors of in-hospital PI development in patients with AMI. This finding has the potential to improve the clinical management of patients admitted in ICCU.