Outcomes Associated With Stage 1 Pressure Injuries: A Retrospective Cohort Study.
Jenny Alderden, Yunchuan Lucy Zhao, Yingying Zhang and 4 others
PMID 30385538WHAT IT FOUND
Nearly one-third of critical care patients with stage 1 pressure injuries worsened to stage 2 or higher.
Older age, higher lactate and creatinine, and lower hemoglobin and oxygen saturation were linked to this worsening, suggesting aggressive offloading is needed early.
Key findings
0132.4% of patients with stage 1 pressure injuries worsened to greater than stage 2.
02Worsening was significantly associated with older age, higher lactate, higher creatinine, lower hemoglobin, and lower oxygen saturation.
03Braden Scale scores were not related to healing, suggesting it is not useful for guiding care planning once a stage 1 injury exists.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Retrospective design limited to data available in electronic health records. Patients with preexisting pressure injuries at admission were excluded, which may have introduced bias. Data on vasopressor infusions and prophylactic dressings were not available. Fever could not be analyzed as a risk factor because almost all patients had a fever. Stage 1 injuries may be under-recognized in patients with darker skin tones, potentially affecting identification accuracy.
Declared interests
The paper was supported by the National Institutes of Health. No other conflicts of interest are reported in the provided text.
The easy way to misread this
Do not assume the Braden Scale helps predict outcomes for patients who already have a stage 1 pressure injury. The study found Braden scores were not related to healing, suggesting it is not useful for guiding care planning in this specific context.