In:
Neurology: Clinical Practice, Ovid Technologies (Wolters Kluwer Health), Vol. 7, No. 1 ( 2017-02), p. 15-25
Abstract:
Pressure ulcers resulting from continuous EEG (cEEG) monitoring in hospitalized patients have gained attention as a preventable medical complication. We measured their incidence and risk factors. Methods: We performed an observational investigation of cEEG-electrode-related pressure ulcers (EERPU) among acutely ill patients over a 22-month period. Variables analyzed included age, sex, monitoring duration, hospital location, application methods, vasopressor usage, nutritional status, skin allergies, fever, and presence/severity of EERPU. We examined risk for pressure ulcers vs monitoring duration using Kaplan-Meyer survival analysis, and performed multivariate risk assessment using Cox proportional hazard model. Results: Among 1,519 patients, EERPU occurred in 118 (7.8%). Most (n = 109, 92.3%) consisted of hyperemia only without skin breakdown. A major predictor was monitoring duration, with 3-, 5-, and 10-day risks of 16%, 32%, and 60%, respectively. Risk factors included older age (mean age 60.65 vs 50.3, p 〈 0.01), care in an intensive care unit (9.37% vs 5.32%, p 〈 0.01), lack of a head wrap (8.31% vs 27.3%, p = 0.02), use of vasopressors (16.7% vs 9.64%, p 〈 0.01), enteral feeding (11.7% vs 5.45%, p = 0.04), and fever (18.4% vs 9.3%, p 〈 0.01). Elderly patients (71–80 years) were at higher risk (hazard ratio 6.84 [1.95–24], p 〈 0.01), even after accounting for monitoring time and other pertinent variables in multivariate analysis. Conclusions: EERPU are uncommon and generally mild . Elderly patients and those with more severe illness have higher risk of developing EERPU, and the risk increases as a function of monitoring duration.
Type of Medium:
Online Resource
ISSN:
2163-0402
,
2163-0933
DOI:
10.1212/CPJ.0000000000000312
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2017
detail.hit.zdb_id:
2645818-4
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