Análise do risco de lesão por pressão em pacientes críticos através da Escala de Cubbin & Jackson

Abstract

This study aimed to analyze the risk of pressure injury in critically ill patients admitted to the intensive care unit using the Cubbin & Jackson scale. This is a quantitative, observational, analytical and cross-sectional study with a sample of 60 participants, composed of patients admitted to the Intensive Care Unit (ICU) of a Public Hospital in a capital city in the Northeast of Brazil. Sociodemographic and clinical data were collected and the Cubbin & Jackson scale was applied every 24 hours to analyze the risk of developing pressure injury, from the day of admission to discharge. Data analysis was performed using the R Studio statistical software, using descriptive and inferential statistics. Of the 60 research participants, six (10%) developed PU. Regarding sociodemographic and clinical characteristics, the sample was predominantly female (45, 75%), brown skin color (48, 80%), age group between 56 and 70 years old (22, 36.7%), hospitalized between one and five days (36, 60%), with systemic arterial hypertension (23, 38.3%) with surgical reason for hospitalization (17, 28.3%), with oncological diagnosis (30, 50%), and using Dexmedetomidine (12, 20%), Fentanyl (nine, 15%), Norepinephrine (17, 28.3%) and Piperacillin (nine, 15%). Among the group that developed LPP in the study, there was a predominance of female individuals (four, 66.6%), brown skin color (five, 83.3%), without underlying diseases (four, 66.6%), hospitalized for respiratory causes (three, 50%), with an oncological diagnosis (three, 50%). Regarding risk stratification, seven (11.4%) were classified as high risk, of which three (50%) presented the lesion. Regarding the classification and location of LPP appearance, stage two (six, 100%) was predominant, in the sacral region (four, 66.7%). Among the factors analyzed in the development of LPP, correlating with risk stratification, individuals aged between 56 and 70 years, hospitalized between six and ten days, using norepinephrine and sedatives presented the highest Odds Ratio (OR), however, without a statistically significant p value. Regarding race, browns, when compared to blacks, presented an OR of 0.17, indicating a protective factor for PU, in addition to presenting a value with statistical significance (p<0.001). The Cubbin & Jackson Scale was able to analyze the risk of developing pressure injuries in critically ill patients. It is essential to expand studies using this tool to ensure its predictive capacity and allow its application in ICUs in the country.