Incidence and Risk Factors of Noninvasive Ventilation Device-Related Pressure Skin Injuries: A Retrospective Study

无创通气装置相关压力性皮肤损伤的发生率和危险因素:一项回顾性研究

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Abstract

BACKGROUND AND AIMS: Noninvasive ventilation (NIV) is an established treatment for acute and chronic respiratory failure. Noninvasive ventilation device-related pressure injuries (NIVDRPIs) are the common complication and may reduce adherence to NIV and its effectiveness. The purpose of this study was to investigate the incidence and risk factors of NIVDRPIs in the respiratory intensive care unit of a university hospital. METHODS: Basic demographics, NIV related clinical characteristics, and the results of skin assessment were obtained from the nursing records and the information system. The clinical data were collected to analyze risk factors of NIVDRPIs by univariate analysis and logistic regression analysis. RESULTS: There were 78 patients who used NIV and 78 met the inclusion criteria. The incidence rate of NIVDRPIs was 15.4% (12/78). Most of the PIs developed in the nasal bridge, forehead, and ear; 83.3% and 16.7% were categorized as stage 1 and 2, respectively. In multivariate analysis, albumin level and duration on noninvasive ventilator were identified as independent risk factors of the occurrence of NIVDRPIs. The logistic model showed statistical significance according to the Omnibus Test (p = 0.001). The Hosmer-Lemeshow test (p = 0.91) provided evidence for the goodness of the fit. CONCLUSIONS: The incidence of NIVDRPIs was high, as 15.4% and patients with low albumin levels and long duration on noninvasive ventilator were more likely to develop NIVDRPIs.

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