Sepsis Episodes Caused by Pressure Injuries in Critical Illness: A Retrospective Observational Cohort Study

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Küçükdemirci Kaya P., Kaya A. M., Girgin N. K., Kahveci F. Ş., Akalın E. H., İşçimen R.

Wound Management and Prevention, vol.69, no.4, pp.4-9, 2023 (SCI-Expanded) identifier

  • Publication Type: Article / Article
  • Volume: 69 Issue: 4
  • Publication Date: 2023
  • Doi Number: 10.25270/wmp.22093
  • Journal Name: Wound Management and Prevention
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus
  • Page Numbers: pp.4-9
  • Keywords: Antimicrobial, Critical Illness, Infection, Pressure Injury, Pressure Injury, Resistance, Sepsis
  • Bursa Uludag University Affiliated: Yes

Abstract

BACKGROUND: Critically-ill patients (CIPs) with pressure injuries (PIs) may develop bloodstream infections (BSIs). PURPOSE: To identify predisposing factors and discuss diagnosis and management of sepsis-related PIs in CIPs. METHODS: The records of CIPs in the intensive care unit (ICU) between January 1, 2014, and January 1, 2020, with PI with sepsis-diagnoses and with different site cultures that were positive concurrent with bloodstream-cultures were retrospectively reviewed. RESULTS: Ninety-one sepsis episodes were included in the study. Low albumin level (U = 382.00, P = .006), renal failure (odds ratio [OR], 0.108 [95% CI, 0.015-0.783]; P = .025), and length of ICU stay (U = 130.00, P < .001) were identified as risk factors of BSIs due to PIs. The probability of BSI during a sepsis episode was lower in CIPs with PIs with higher C-reactive protein levels (U = 233.00, P < .001) and whose injury resulted from trauma or surgery (OR, 0.101 [95% CI, 0.016-0.626]; P = .014). The mortality was higher in CIPs with PI-induced BSIs (OR, 0.051 [95% CI, 0.008-0.309]; P = .001). CONCLUSIONS: Pressure injury-induced sepsis was associated with a high risk of 28-day mortality. The findings suggest that CIPs with PI are at increased risk of BSIs if they have low albumin levels, renal-failure, and prolonged ICU stay during sepsis episodes.