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Relationship between a pressure redistributing foam mattress and pressure injuries: An observational prospective cohort study.

ABSTRACT: BACKGROUND AND PURPOSE:Pressure injuries remain a significant health care issue in various settings. The purpose of this study was to examine the relationship between a pressure redistributing foam mattress (PRFM) and the development of pressure injuries. METHODS:This study employed an observational prospective cohort study design. We enrolled 254 participants from the intensive care unit who were at risk of developing pressure injuries. Participants were exposed to either a nonpressure redistributing foam mattress (NPRFM), which was the standard mattress used at the study site, or a PRFM made of viscoelastic, temperature-sensitive, polyurethane memory foam. The patients' assignment to either a PRFM or NPRFM was performed upon their admission, before the study eligibility screening. The relationship between the PRFM and the development of pressure injuries was studied using a logistic regression model. RESULTS:The overall incidence of pressure injuries was 5.9% (15/254) in our study, with 1.6% (2/127) for participants who used a PRFM and 10.2% (13/127) for those using a NPRFM. After adjusting for potential confounding variables, use of a PRFM was associated with an 88% reduced risk of pressure injury development (OR = 0.12, 95% CI: 0.03, 0.56, P = 0.007). The use of a PRFM also contributed to a postponed occurrence of pressure injuries by 4.2 days on average in comparison with that of a NPRFM (P = 0.041). CONCLUSIONS:A PRFM is associated with a significantly reduced incidence and postponed occurrence of pressure injuries. It is recommended to use a PRFM for patients at risk of developing pressure injuries.

SUBMITTER: Bai DL

PROVIDER: S-EPMC7652312 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Relationship between a pressure redistributing foam mattress and pressure injuries: An observational prospective cohort study.

Bai Dorothy Li DL Liu Tsai-Wen TW Chou Hsiu-Ling HL Hsu Yeh-Liang YL

PloS one 20201109 11

<h4>Background and purpose</h4>Pressure injuries remain a significant health care issue in various settings. The purpose of this study was to examine the relationship between a pressure redistributing foam mattress (PRFM) and the development of pressure injuries.<h4>Methods</h4>This study employed an observational prospective cohort study design. We enrolled 254 participants from the intensive care unit who were at risk of developing pressure injuries. Participants were exposed to either a nonpr ...[more]

PMID: 33166300

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Project description:BackgroundThe occurrence of thyroid nodules and goiter increases with age. In general, surgery age is a predictor of perioperative morbidity. In thyroid surgery, there are different data on the role of age on morbidity. We investigated the influence of age on the outcome in thyroid surgery in a prospective single cohort study with a follow-up after 1 year.MethodsTotal thyroidectomy or hemithyroidectomy was performed in euthyroid benign thyroid goiters (n=152). The primary endpoint was surgery duration. The secondary endpoints were weight of resected tissue, body mass index (BMI), amount and type of perioperative and long-term complications, and quality of life (QoL) preoperatively and 1 year postoperatively.ResultsA significant three-way interactive relationship between age, surgery duration, and amount of resected tissue was found. An increase in any of these variables results in an increase in both other variables. The amount of perioperative complications was associated with resected tissue size. The QoL increases significantly after surgery by up to 10% and decreases significantly with age (mean QoL after surgery=84.9 of 100 for the youngest group and 75.7 of 100 for the oldest group). No long-term complications were recorded.ConclusionThe number of thyroid operations, especially of benign thyroid goiters, decreases annually in Germany. This can be explained by the fact that, on the one hand, the surgical indications are made more restrictive as conspicuous nodes are better clarified by improved technical aids. On the other hand, conservative measures (i.e. L-thyroxine and iodide administration) are used to achieve a size regimen of the goiter. Our results show that perioperative complications increase with patients' age and surgery duration. However, the more restrictive surgical decision also entails the risk that patients will have to be operated at an older age and possibly with a bigger goiter, which is associated with higher operative morbidity. Therefore, in addition to the possibility of conservative therapy of the symptomatic goiter, the affected patients should also be thoroughly informed about the option to perform elective early thyroid surgery with regard to improved postoperative QoL and to keep the overall stress at a minimum for elderly patients.

Project description:Background:Considering the adverse effects of sleep disturbance in critical care settings, accurate assessment could aid therapy; however, methodological inadequacies mean that no viable option is currently available. Research in healthy population has recently shown that a non-wearable sleep measurement device placed under the mattress of the bed could be beneficial in intensive care settings. Therefore, we aimed to validate this device compared with polysomnography (PSG) and to assess how it related to subjective sleep evaluations. Methods:This observational study measured the sleep of critically ill adult patients. The primary goal was to validate the Nemuri SCAN (NSCAN; Paramount Bed Co., Ltd., Tokyo, Japan) against the reference standard PSG for 24?h. The secondary goal was to evaluate the association between the objective parameters obtained from NSCAN and PSG and the subjective report data obtained using the Richards-Campbell Sleep Questionnaire (RCSQ) for the nighttime. Results:Eleven participants were evaluated. The median of the total sleep time scored by PSG was 456.0 (353.0-517.5) min during the nighttime and 305.0 (186.2-542.5) min during the daytime. PSG over 24?h revealed significant decreases in restorative sleep, with excessive daytime sleep, but with a normal quantity of nighttime sleep. The agreement, sensitivity, and specificity rates (with 95% confidence intervals) for the NSCAN compared with PSG were 68.4% (67.9-69.0%), 90.1% (89.7-90.6%), and 38.7% (37.9-39.7%), respectively. The median RCSQ value when subjectively evaluating nighttime sleep was 68.0 (26.3-83.5); this showed no correlation with the NSCAN sleep parameters, despite a positive correlation with the ratio of the stage N2 isolated or combined with restorative sleep in the PSG assessment. Conclusions:NSCAN had moderate agreement, high sensitivity, and poor specificity in intensive care settings, which is most likely due to its inability to identify immobile wakefulness often observed in critically ill patients or sleep depth. This remains a barrier to its use in the assessment of subjective sleep quality. Trial registration:This investigation was part of an interventional trial registered with the University Hospital Medical Information Network Individual Clinical Trials Registry (UMIN000026350, http://www.umin.ac.jp/icdr/index-j.html) on March 1, 2017.

Dataset Information

Relationship between a pressure redistributing foam mattress and pressure injuries: An observational prospective cohort study.

Publications

Relationship between a pressure redistributing foam mattress and pressure injuries: An observational prospective cohort study.

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