Risk factors for pressure injuries among critical care patients: A systematic review.
Jenny Alderden, June Rondinelli, Ginette Pepper and 2 others
PMID 28384533WHAT IT FOUND
For ICU patients, vasopressor infusion, conditions affecting perfusion and mobility or activity were pressure injury risk factors supported by higher-quality studies.
Turning and repositioning findings were conflicting.
Key findings
01Vasopressor infusion was independently predictive of pressure injury development in four studies, including both high-quality studies.
02Perfusion-related diagnoses emerged as independent risk factors in six studies, including all four high-quality studies.
03Mobility and activity level were independently predictive of pressure injuries in one high-quality study and one low-quality study.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The review combined observational studies with different definitions of pressure injury and risk factors, so results were not pooled. Most included studies were low or very low quality, and several lacked enough pressure injury events for stable estimates. Several studies measured perfusion or vasopressor exposure only at selected times, not throughout the ICU stay. Many studies excluded patients admitted with a pre-existing pressure injury. This limited skin status findings. The search mainly used English-language databases, so non-English studies may have been missed.
The easy way to misread this
Do not conclude that vasopressors cause pressure injuries. The review found links, not proof of cause, and study quality varied.