Patient risk factors for pressure ulcer development: systematic review.
TL;DR: Overall there is no single factor which can explain pressure ulcer risk, rather a complex interplay of factors which increase the probability of pressure ulcers development.
About: This article is published in International Journal of Nursing Studies.The article was published on 2013-07-01 and is currently open access. It has received 537 citations till now. The article focuses on the topics: Risk factor & Observational study.
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TL;DR: A 2018 retrospective analysis of Medicare beneficiaries identified that ∼8.2 million people had wounds with or without infections, with highest expenses were for surgical wounds followed by diabetic foot ulcers, with a higher trend toward costs associated with outpatient wound care compared with inpatient.
Abstract: Significance: A 2018 retrospective analysis of Medicare beneficiaries identified that ∼8.2 million people had wounds with or without infections. Medicare cost estimates for acute and chronic wound treatments ranged from $28.1 billion to $96.8 billion. Highest expenses were for surgical wounds followed by diabetic foot ulcers, with a higher trend toward costs associated with outpatient wound care compared with inpatient. Increasing costs of health care, an aging population, recognition of difficult-to-treat infection threats such as biofilms, and the continued threat of diabetes and obesity worldwide make chronic wounds a substantial clinical, social, and economic challenge. Recent Advances: Chronic wounds are not a problem in an otherwise healthy population. Underlying conditions ranging from malnutrition, to stress, to metabolic syndrome, predispose patients to chronic, nonhealing wounds. From an economic point of view, the annual wound care products market is expected to reach $15-22 billion by 2024. The National Institutes of Health's (NIH) Research Portfolio Online Reporting Tool (RePORT) now lists wounds as a category. Future Directions: A continued rise in the economic, clinical, and social impact of wounds warrants a more structured approach and proportionate investment in wound care, education, and related research.
544 citations
Cites background from "Patient risk factors for pressure u..."
...The incidence of PU increases with age and is promoted by a lack of skin perfusion, moisture, and nutrition.(14) In the United States around 2....
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Journal Article•
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TL;DR: The Mens’ Health Urbanathlon offers a chance for sedentary office workers to get up from their chairs, with recent research in the Archives of Internal Medicine showing that sitting is a risk factor for all-cause mortality.
Abstract: Heads and seizures, knees and toes A competitor climbs the monkey bars in front of the Sydney Harbour Bridge during the 2012 Mens’ Health Urbanathlon last month. The 10.7 km race through the Sydney CBD includes challenges such as hoisting a 10 kg sandbag and clambering over barricades. It offers a chance for sedentary office workers to get up from their chairs, with recent research in the Archives of Internal Medicine showing that sitting is a risk factor for all-cause mortality.
291 citations
University of Leeds1, Leeds Teaching Hospitals NHS Trust2, University of Birmingham3, Leeds Community Healthcare NHS Trust4, Columbia University5, Maastricht University6, University of Nebraska Medical Center7, Boston University8, University of Manchester9, University of Bradford10, University of Southampton11, Radboud University Nijmegen Medical Centre12, Eindhoven University of Technology13, Tel Aviv University14
TL;DR: The new proposed conceptual framework provides the basis for understanding the critical determinants of pressure ulcer development and has the potential to influence risk assessment guidance and practice and to underpin future research to explore the role of individual risk factors conceptually and operationally.
Abstract: Aim. This paper discusses the critical determinants of pressure ulcer development and proposes a new pressure ulcer conceptual framework. Background. Recent work to develop and validate a new evidence-based pressure ulcer risk assessment framework was undertaken. This formed part of a Pressure UlceR Programme Of reSEarch (RP-PG-0407-10056), funded by the National Institute for Health Research. The foundation for the risk assessment component incorporated a systematic review and a consensus study that highlighted the need to propose a new conceptual framework. Design. Discussion Paper. Data Sources. The new conceptual framework links evidence from biomechanical, physiological and epidemiological evidence, through use of data from a systematic review (search conducted March 2010), a consensus study (conducted December 2010–2011) and an international expert group meeting (conducted December 2011). Implications for Nursing. A new pressure ulcer conceptual framework incorporating key physiological and biomechanical components and their impact on internal strains, stresses and damage thresholds is proposed. Direct and key indirect causal factors suggested in a theoretical causal pathway are mapped to the physiological and biomechanical components of the framework. The new proposed conceptual framework provides the basis for understanding the critical determinants of pressure ulcer development and has the potential to influence risk assessment guidance and practice. It could also be used to underpin future research to explore the role of individual risk factors conceptually and operationally.
275 citations
Cites background or methods from "Patient risk factors for pressure u..."
...The first two sources included a systematic review of pressure ulcer risk factors (Coleman et al. 2013) and a consensus study (Coleman et al. in press)....
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...Identifying the risk factors independently associated with pressure ulcer development, the systematic review (Coleman et al. 2013) provides a clearer understanding of the critical pressure ulcer risk factors (recognizing that some ‘important factors’ may still be lacking in confirmatory evidence…...
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...Finally, there is equivocal evidence that race or gender is important to pressure ulcer development (Coleman et al. 2013)....
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...The meeting was planned, so that members had access to the outcomes of the consensus study (Coleman et al. in press), evidence of the systematic review (Coleman et al. 2013) and causal factor terminology prior to the face-to-face meeting....
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...To agree the risk factors to be included in the MDS and RAF, the expert group considered the evidence of the systematic review (Coleman et al. 2013), wider scientific evidence drawn from the expertise of the group and clinical resonance (i.e. its considered importance to clinical practice)....
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Kent Hospital1, Johns Hopkins University2, Winthrop University3, Stony Brook University4, Winston-Salem State University5, Vanderbilt University6, University of Illinois at Chicago7, Boston University8, Baylor College of Medicine9, University of Iowa10, University of Pennsylvania11, Wake Forest University12, University of Western Ontario13, Smith & Nephew14, University of Miami15, Loyola University Chicago16, University of Washington17, University of Arkansas for Medical Sciences18, University of Maryland, Baltimore19, National Institutes of Health20, Duke University21
TL;DR: The Association of Specialty Professors held a workshop, summarized in this article, to explore the current state of knowledge and research challenges, engage investigators across disciplines, and identify research questions to guide future study of age‐associated changes in chronic wound healing.
Abstract: Older adults are more likely to have chronic wounds than younger people, and the effect of chronic wounds on quality of life is particularly profound in this population. Wound healing slows with age, but the basic biology underlying chronic wounds and the influence of age-associated changes on wound healing are poorly understood. Most studies have used in vitro approaches and various animal models, but observed changes translate poorly to human healing conditions. The effect of age and accompanying multimorbidity on the effectiveness of existing and emerging treatment approaches for chronic wounds is also unknown, and older adults tend to be excluded from randomized clinical trials. Poorly defined outcomes and variables; lack of standardization in data collection; and variations in the definition, measurement, and treatment of wounds also hamper clinical studies. The Association of Specialty Professors, in conjunction with the National Institute on Aging and the Wound Healing Society, held a workshop, summarized in this article, to explore the current state of knowledge and research challenges, engage investigators across disciplines, and identify research questions to guide future study of age-associated changes in chronic wound healing.
243 citations
TL;DR: It is suggested that the burden of pressure injuries remains substantial with over one in ten adult patients admitted to hospitals affected, and the need to dedicate resources to prevention and treatment on pressure injuries is supported.
184 citations
References
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TL;DR: The Consort 2010 Statement as discussed by the authors has been used worldwide to improve the reporting of randomised controlled trials and has been updated by Schulz et al. in 2010, based on new methodological evidence and accumulating experience.
Abstract: The CONSORT statement is used worldwide to improve the reporting of randomised controlled trials. Kenneth Schulz and colleagues describe the latest version, CONSORT 2010, which updates the reporting guideline based on new methodological evidence and accumulating experience. To encourage dissemination of the CONSORT 2010 Statement, this article is freely accessible on bmj.com and will also be published in the Lancet, Obstetrics and Gynecology, PLoS Medicine, Annals of Internal Medicine, Open Medicine, Journal of Clinical Epidemiology, BMC Medicine, and Trials.
11,165 citations
TL;DR: The 2010 version of the CONSORT Statement is described, which updates the previous reporting guideline based on new methodological evidence and accumulated experience.
Abstract: Kenneth Schulz and colleagues describe the 2010 version of the CONSORT Statement, which updates the previous reporting guideline based on new methodological evidence and accumulated experience.
5,090 citations
"Patient risk factors for pressure u..." refers background in this paper
...Smoking 2 of 4 (50%) 1 MQS – Suriadi et al. (2008) 1 LQS – Suriadi et al....
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...Smoking 2 of 4 (50%) 1 MQS – Suriadi et al. (2008) 1 LQS – Suriadi et al. (2007) 2 LQS – Feuchtinger et al....
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Book•
30 Nov 2000
TL;DR: The second edition of this best-selling book has been thoroughly revised and expanded to reflect the significant changes and advances made in systematic reviewing.
Abstract: The second edition of this best-selling book has been thoroughly revised and expanded to reflect the significant changes and advances made in systematic reviewing. New features include discussion on the rationale, meta-analyses of prognostic and diagnostic studies and software, and the use of systematic reviews in practice.
2,601 citations
TL;DR: The specialty of obstetrics and gynaecology will benefit from several related groups already working within the Cochrane Collaboration, and it is hoped that the ‘wooden spoon’ can be discarded from the authors' ranks for good.
Abstract: Summary In the current era of patients seeking better information, managers seeking cost-effective treatments, clinicians struggling to keep up with the expanding medical literature, and professional groups requiring continuing medical education, there is a clear need for up-to-date and relevant systematic reviews of the effectiveness of treatment within our specialty. Such reviews will play an increasing role in the education of health professionals and lay people, in the evolution of the health service and in the direction of future research. The Cochrane Collaboration provides the infrastructure for the development and dissemination of these reviews. The specialty of obstetrics and gynaecology will benefit from several related groups already working within the Cochrane Collaboration (Pregnancy and Childbirth, Subfertility, Menstrual Disorders and Incontinence). Other groups are in the process of, or likely to, register in the near future (Fertility Control, Gynaecological Cancer). However, the need and demand for a large number of systematic reviews exceeds the current capacity of those who have committed themselves to prepare and maintain such reviews, and substantial challenges remain. However, there is every reason to believe that a concerted effort over many years will be worth while. Earlier in this commentary, obstetrics and gynaecology was referred to as the specialty most deserving of the ‘wooden spoon’ for its lack of evidence-based practice. With the development of various gynaecological groups within the Collaboration, we hope that the ‘wooden spoon’ can be discarded from our ranks for good.
2,561 citations
2,328 citations