Pressure injuries in elderly with acute myocardial infarction

Klara Komici,1 Dino F Vitale,2 Dario Leosco,1 Angela Mancini,1 Graziamaria Corbi,3 Leonardo Bencivenga,1 Alessandro Mezzani,4 Bruno Trimarco,5 Carmine Morisco,5 Nicola Ferrara,1,2 Giuseppe Rengo1,2 1Division of Geriatrics, Department of Translational Medical Sciences, University of Naples Federico...

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Autores principales:	Komici K, Vitale DF, Leosco D, Mancini A, Corbi G, Bencivenga L, Mezzani A, Trimarco B, Morisco C, Ferrara N, Rengo G
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	pressure ulcers mini nutritional assessment Norton Scale acute myocardial systolic dysfunction. Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/2b306fb55ea24aaca7c3cb1600a612a0
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spelling	oai:doaj.org-article:2b306fb55ea24aaca7c3cb1600a612a02021-12-02T03:00:15ZPressure injuries in elderly with acute myocardial infarction1178-1998https://doaj.org/article/2b306fb55ea24aaca7c3cb1600a612a02017-09-01T00:00:00Zhttps://www.dovepress.com/pressure-injuries-in-elderly-with-acute-myocardial-infarction-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Klara Komici,1 Dino F Vitale,2 Dario Leosco,1 Angela Mancini,1 Graziamaria Corbi,3 Leonardo Bencivenga,1 Alessandro Mezzani,4 Bruno Trimarco,5 Carmine Morisco,5 Nicola Ferrara,1,2 Giuseppe Rengo1,2 1Division of Geriatrics, Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy; 2Cardiac Rehabilitation Division, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Telese Terme, Italy; 3Department of Medicine and Health Sciences, University of Molise Campobasso, Campobasso, Italy; 4Cardiac Rehabilitation Division, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Veruno, Veruno, Italy; 5Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy Objectives: 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.Patients and methods: 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.Results: 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.Conclusion: 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. Keywords: pressure injury, Mini Nutritional Assessment, Norton Scale, acute myocardial systolic dysfunctionKomici KVitale DFLeosco DMancini ACorbi GBencivenga LMezzani ATrimarco BMorisco CFerrara NRengo GDove Medical Pressarticlepressure ulcersmini nutritional assessmentNorton Scaleacute myocardial systolic dysfunction.GeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 12, Pp 1495-1501 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	pressure ulcers mini nutritional assessment Norton Scale acute myocardial systolic dysfunction. Geriatrics RC952-954.6
spellingShingle	pressure ulcers mini nutritional assessment Norton Scale acute myocardial systolic dysfunction. Geriatrics RC952-954.6 Komici K Vitale DF Leosco D Mancini A Corbi G Bencivenga L Mezzani A Trimarco B Morisco C Ferrara N Rengo G Pressure injuries in elderly with acute myocardial infarction
description	Klara Komici,1 Dino F Vitale,2 Dario Leosco,1 Angela Mancini,1 Graziamaria Corbi,3 Leonardo Bencivenga,1 Alessandro Mezzani,4 Bruno Trimarco,5 Carmine Morisco,5 Nicola Ferrara,1,2 Giuseppe Rengo1,2 1Division of Geriatrics, Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy; 2Cardiac Rehabilitation Division, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Telese Terme (BN), Telese Terme, Italy; 3Department of Medicine and Health Sciences, University of Molise Campobasso, Campobasso, Italy; 4Cardiac Rehabilitation Division, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Veruno, Veruno, Italy; 5Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy Objectives: 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.Patients and methods: 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.Results: 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.Conclusion: 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. Keywords: pressure injury, Mini Nutritional Assessment, Norton Scale, acute myocardial systolic dysfunction
format	article
author	Komici K Vitale DF Leosco D Mancini A Corbi G Bencivenga L Mezzani A Trimarco B Morisco C Ferrara N Rengo G
author_facet	Komici K Vitale DF Leosco D Mancini A Corbi G Bencivenga L Mezzani A Trimarco B Morisco C Ferrara N Rengo G
author_sort	Komici K
title	Pressure injuries in elderly with acute myocardial infarction
title_short	Pressure injuries in elderly with acute myocardial infarction
title_full	Pressure injuries in elderly with acute myocardial infarction
title_fullStr	Pressure injuries in elderly with acute myocardial infarction
title_full_unstemmed	Pressure injuries in elderly with acute myocardial infarction
title_sort	pressure injuries in elderly with acute myocardial infarction
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/2b306fb55ea24aaca7c3cb1600a612a0
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Pressure injuries in elderly with acute myocardial infarction

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