Alternating Pressure Air Mattresses in the Intensive Care Unit: A Cost-Effective Strategy for Preventing Stage III–IV Pressure Injuries: A Retrospective Cohort Study  

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Efe S., Ateş C., Cengizhan M. S., Hancı Yılmaztürk P., İnal V.

CLINICS, cilt.81, sa.0, ss.1-6, 2026 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 81 Sayı: 0
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1016/j.clinsp.2026.100877
  • Dergi Adı: CLINICS
  • Derginin Tarandığı İndeksler: Scopus, Science Citation Index Expanded (SCI-EXPANDED), EMBASE, MEDLINE, Directory of Open Access Journals
  • Sayfa Sayıları: ss.1-6
  • Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
  • Bursa Uludağ Üniversitesi Adresli: Evet

Özet

Background: Pressure injuries (PIs) are common, preventable complications in intensive care units (ICUs) that increase morbidity, mortality, and healthcare costs. Alternating pressure air mattresses (APAMs) are proposed to reduce PI incidence, but real-world effectiveness data remain limited.

Objectives: To evaluate the impact of APAM use on PI incidence, clinical outcomes, and cost-effectiveness in critically ill ICU patients.

Methods: This retrospective cohort study in a tertiary 10-bed ICU compared patients before and after APAM implementation. Multivariate logistic regression identified independent PI risk factors. A cost-effectiveness model was developed based on NNT and treatment costs.

Results: APAM use was associated with a 33% reduction in overall PI risk (RR 0.67; 95% CI 0.45–0.98) and an 84% reduction in Stage III–IV ulcers (RR 0.16; 95% CI 0.05–0.53). The NNT was 23 to prevent one PI, equating to an estimated net cost saving of approximately USD 121,750 over five years for a 10-bed ICU. Length of stay (LOS) and prolonged mechanical ventilation were the strongest independent PI predictors, increasing risk by 19% and 13% per day, respectively. APAMs’ protective effect was attenuated in patients with prolonged LOS and ventilation. Sepsis and respiratory failure increased PI risk in univariate analysis but lost significance after adjustment, suggesting mediation by LOS and ventilation duration. APAMs showed limited efficacy in septic patients, indicating the need for multimodal prevention strategies.

Conclusions: APAMs significantly reduce severe PI incidence and related treatment requirements in critically ill patients, offering a cost-effective intervention for ICU pressure injury prevention. Their benefit may be limited by factors such as prolonged hospitalization and ventilation. Future adequately powered multicenter randomized trials are warranted to validate these findings, particularly in diabetic and septic subgroups.