Prevalence of graduated compression stocking-associated pressure injuries in surgical intensive care units

Deborah B Hobson; Tracy Y Chang; Jonathan K Aboagye; Brandyn D Lau; Hasan M Shihab; Betsy Fisher; Samantha Young; Nancy Sujeta; Dauryne L Shaffer; Victor O Popoola; Peggy S Kraus; Gina Knorr; Norma E Farrow; Michael B Streiff; Elliott R Haut

doi:10.1016/j.jcrc.2017.02.016

Prevalence of graduated compression stocking-associated pressure injuries in surgical intensive care units

J Crit Care. 2017 Aug:40:1-6. doi: 10.1016/j.jcrc.2017.02.016. Epub 2017 Feb 27.

Authors

Affiliations

¹ Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD; The Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, MD. Electronic address: dhobson1@jhmi.edu.
² New York Medical College, School of Medicine, Valhalla, NY. Electronic address: tracyc.lab@gmail.com.
³ Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: jaboagy1@jhmi.edu.
⁴ Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD; The Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, MD; Division of Health Sciences Informatics, The Johns Hopkins University School of Medicine, Baltimore, MD; Department of Health Policy and Management, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland. Electronic address: blau2@jhmi.edu.
⁵ Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: hshihab1@jhmi.edu.
⁶ Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: bfishe13@jhmi.edu.
⁷ Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: syoung40@jhmi.edu.
⁸ Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: nsujeta@jhmi.edu.
⁹ Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: dshaffe1@jhmi.edu.
¹⁰ Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: vpopool1@jhmi.edu.
¹¹ Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, MD. Electronic address: pkraus2@jhmi.edu.
¹² Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: gdomeni1@jhmi.edu.
¹³ Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: nfarrow1@jhmi.edu.
¹⁴ The Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, MD; Division of Hematology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD; Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: mstreif1@jhmi.edu.
¹⁵ Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD; The Armstrong Institute for Patient Safety and Quality, Johns Hopkins Medicine, Baltimore, MD; Department of Health Policy and Management, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland; Department of Emergency Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD; Department of Anesthesiology and Critical Care Medicine (ACCM), The Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: ehaut1@jhmi.edu.

PMID: 28284096
DOI: 10.1016/j.jcrc.2017.02.016

Abstract

Purpose: This study aimed to determine the prevalence of static graduated compression stocking (sGCS)-associated pressure injury among patients in surgical intensive care units (ICUs).

Methods: We retrospectively reviewed data from wound care rounds between April 2011 and June 2012 at 3 surgical ICUs at an urban, tertiary care hospital. Patients with sGCS-associated pressure injury were identified and descriptive analysis was performed on their demographic, perioperative, and postoperative characteristics.

Results: We examined 1787 individual patients during 2391 patient encounters. A total of 129 (7.2%) of patients developed pressure injuries. Forty patients (2.2%) developed sGCS-associated pressure injury. Static GCS-associated pressure injury accounted for 31% (40/129) of all pressure injuries and 74% (40/54) of all medical device-related pressure injury. Eighteen (45%) and 6 (15%) developed stage 1 and 2 pressure injury, respectively, and 16 (40%) developed deep tissue injuries. The mean age of our patients was 64.7 years, about half (47.5%) were male, and their mean Acute Physiology and Chronic Health Evaluation II score was 18.8. Many had comorbid conditions, including obesity (44.5%) and diabetes (42.5%), and required mechanical ventilation (45%).

Conclusions: Pressure injuries are a notable complication of sGCS in surgical ICU patients. Appropriate measures are required to help avoid this potentially preventable harm.

Keywords: Intensive care; Pressure injury; Static graduated compression stockings; Surgical patients; Venous thromboembolism.

MeSH terms

Adult
Aged
Cohort Studies
Female
Hospitals, University
Humans
Intensive Care Units
Leg
Male
Maryland / epidemiology
Middle Aged
Postoperative Complications / epidemiology
Postoperative Complications / etiology
Pressure Ulcer / epidemiology*
Pressure Ulcer / etiology
Prevalence
Retrospective Studies
Stockings, Compression / adverse effects*