Pressure ulcers in palliative ward patients: hyponatremia and low blood pressure as indicators of risk

Danuta Sternal,1 Krzysztof Wilczyński,2 Jan Szewieczek2 1Department of Nursing and Paramedical Sciences, Faculty of Health Sciences, University of Bielsko-Biala, Bielsko-Biala, 2Department of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland Backgro...

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Autores principales:	Sternal D, Wilczyński K, Szewieczek J
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	pressure ulcers palliative care advanced illness Waterlow score hyponatremia blood pressure Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/f33c59186d5848cc8b7ff0620c91fe78
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spelling	oai:doaj.org-article:f33c59186d5848cc8b7ff0620c91fe782021-12-02T00:25:12ZPressure ulcers in palliative ward patients: hyponatremia and low blood pressure as indicators of risk1178-1998https://doaj.org/article/f33c59186d5848cc8b7ff0620c91fe782016-12-01T00:00:00Zhttps://www.dovepress.com/pressure-ulcers-in-palliative-ward-patients-hyponatremia-and-low-blood-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Danuta Sternal,1 Krzysztof Wilczyński,2 Jan Szewieczek2 1Department of Nursing and Paramedical Sciences, Faculty of Health Sciences, University of Bielsko-Biala, Bielsko-Biala, 2Department of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland Background: Prevention strategies for pressure ulcer formation remain critical in patients with an advanced illness. We analyzed factors associated with the development of pressure ulcers in patients hospitalized in a palliative care ward setting.Patients and methods: This study was a retrospective analysis of 329 consecutive patients with a mean age (± standard deviation) of 70.4±11.8 years (range: 30–96 years, median 70.0 years; 55.3% women), who were admitted to the Palliative Care Department between July 2012 and May 2014.Results: Patients were hospitalized for mean of 24.8±31.4 days (1–310 days, median 14 days). A total of 256 patients (77.8%) died in the ward and 73 patients (22.2%) were discharged. Two hundred and six patients (62.6%) did not develop pressure ulcers during their stay in the ward, 84 patients (25.5%) were admitted with pressure ulcers, and 39 patients (11.9%) developed pressure ulcers in the ward. Four factors assessed at admission appear to predict the development of pressure ulcers in the multivariate logistic regression model: Waterlow score (odds ratio [OR] =1.140, 95% confidence interval [CI] =1.057–1.229, P=0.001), transfer from other hospital wards (OR =2.938, 95% CI =1.339–6.448, P=0.007), hemoglobin level (OR =0.814, 95% CI =0.693–0.956, P=0.012), and systolic blood pressure (OR =0.976, 95% CI =0.955–0.997, P=0.023). Five other factors assessed during hospitalization appear to be associated with pressure ulcer development: mean evening body temperature (OR =3.830, 95% CI =1.729–8.486, P=0.001), mean Waterlow score (OR =1.194, 95% CI =1.092–1.306, P<0.001), the lowest recorded sodium concentration (OR =0.880, 95% CI =0.814–0.951, P=0.001), mean systolic blood pressure (OR =0.956, 95% CI =0.929–0.984, P=0.003), and the lowest recorded hemoglobin level (OR =0.803, 95% CI =0.672–0.960, P=0.016).Conclusion: Hyponatremia and low blood pressure may contribute to the formation of pressure ulcers in patients with an advanced illness. Keywords: pressure ulcers, palliative care, advanced illness, Waterlow score, hyponatremia, blood pressureSternal DWilczyński KSzewieczek JDove Medical Pressarticlepressure ulcerspalliative careadvanced illnessWaterlow scorehyponatremiablood pressureGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 12, Pp 37-44 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	pressure ulcers palliative care advanced illness Waterlow score hyponatremia blood pressure Geriatrics RC952-954.6
spellingShingle	pressure ulcers palliative care advanced illness Waterlow score hyponatremia blood pressure Geriatrics RC952-954.6 Sternal D Wilczyński K Szewieczek J Pressure ulcers in palliative ward patients: hyponatremia and low blood pressure as indicators of risk
description	Danuta Sternal,1 Krzysztof Wilczyński,2 Jan Szewieczek2 1Department of Nursing and Paramedical Sciences, Faculty of Health Sciences, University of Bielsko-Biala, Bielsko-Biala, 2Department of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland Background: Prevention strategies for pressure ulcer formation remain critical in patients with an advanced illness. We analyzed factors associated with the development of pressure ulcers in patients hospitalized in a palliative care ward setting.Patients and methods: This study was a retrospective analysis of 329 consecutive patients with a mean age (± standard deviation) of 70.4±11.8 years (range: 30–96 years, median 70.0 years; 55.3% women), who were admitted to the Palliative Care Department between July 2012 and May 2014.Results: Patients were hospitalized for mean of 24.8±31.4 days (1–310 days, median 14 days). A total of 256 patients (77.8%) died in the ward and 73 patients (22.2%) were discharged. Two hundred and six patients (62.6%) did not develop pressure ulcers during their stay in the ward, 84 patients (25.5%) were admitted with pressure ulcers, and 39 patients (11.9%) developed pressure ulcers in the ward. Four factors assessed at admission appear to predict the development of pressure ulcers in the multivariate logistic regression model: Waterlow score (odds ratio [OR] =1.140, 95% confidence interval [CI] =1.057–1.229, P=0.001), transfer from other hospital wards (OR =2.938, 95% CI =1.339–6.448, P=0.007), hemoglobin level (OR =0.814, 95% CI =0.693–0.956, P=0.012), and systolic blood pressure (OR =0.976, 95% CI =0.955–0.997, P=0.023). Five other factors assessed during hospitalization appear to be associated with pressure ulcer development: mean evening body temperature (OR =3.830, 95% CI =1.729–8.486, P=0.001), mean Waterlow score (OR =1.194, 95% CI =1.092–1.306, P<0.001), the lowest recorded sodium concentration (OR =0.880, 95% CI =0.814–0.951, P=0.001), mean systolic blood pressure (OR =0.956, 95% CI =0.929–0.984, P=0.003), and the lowest recorded hemoglobin level (OR =0.803, 95% CI =0.672–0.960, P=0.016).Conclusion: Hyponatremia and low blood pressure may contribute to the formation of pressure ulcers in patients with an advanced illness. Keywords: pressure ulcers, palliative care, advanced illness, Waterlow score, hyponatremia, blood pressure
format	article
author	Sternal D Wilczyński K Szewieczek J
author_facet	Sternal D Wilczyński K Szewieczek J
author_sort	Sternal D
title	Pressure ulcers in palliative ward patients: hyponatremia and low blood pressure as indicators of risk
title_short	Pressure ulcers in palliative ward patients: hyponatremia and low blood pressure as indicators of risk
title_full	Pressure ulcers in palliative ward patients: hyponatremia and low blood pressure as indicators of risk
title_fullStr	Pressure ulcers in palliative ward patients: hyponatremia and low blood pressure as indicators of risk
title_full_unstemmed	Pressure ulcers in palliative ward patients: hyponatremia and low blood pressure as indicators of risk
title_sort	pressure ulcers in palliative ward patients: hyponatremia and low blood pressure as indicators of risk
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/f33c59186d5848cc8b7ff0620c91fe78
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Pressure ulcers in palliative ward patients: hyponatremia and low blood pressure as indicators of risk

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