Perioperative Risk Factors of Postoperative Pressure Injuries in Patients after Surgical Hematoma Evacuation of Intracranial Hemorrhage: A Retrospective Cohort Study.
On-Yu Choi, Youn-Jung Son
PMID 40341016WHAT IT FOUND
After craniotomy or craniectomy for intracranial bleeding, 103 of 386 patients developed pressure injuries, most often on the coccyx and stage 2.
Age 65 or older, postoperative packed red blood cell transfusion, and ICU stay over 7 days were linked with greater risk.
Key findings
01103 of the 386 patients developed postoperative pressure injuries; the coccyx was the most common site (56 cases, 38.9%) and most injuries were stage 2 (69 cases, 67%).
02In adjusted analysis, age 65 years or older was associated with 2.66 times greater risk, postoperative packed red blood cell transfusion with 3.81 times greater risk, and ICU stay of 7 days or more with 7.19 times greater risk.
03Among the 103 patients with pressure injuries, 43 (41.7%) developed them 14 or more days after surgery.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was done at one hospital with a relatively small number of neurosurgery patients, so the results may not apply to other units. Pressure injuries were identified from electronic records, so the study could not track changes in pressure injury stage over time or changes in prevention strategies over the 10-year period. Some records were missing, including hospital admission details, fall history, nutrition therapy, and changes in consciousness and mobility. The study did not record blood loss during surgery, the reason for transfusion, or the hemoglobin level at transfusion, so the transfusion association may be mixed up with how sick the patient was. Nurse knowledge, skills, and awareness of pressure injury prevention may have affected early detection.
The easy way to misread this
Do not read the 3.81 times greater risk after postoperative packed red blood cell transfusion as proof that the transfusion caused pressure injuries. This was a retrospective single hospital study, and the records did not include blood loss, transfusion indication, or hemoglobin level at transfusion.