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Incidence And Predictor Variables Of Pressure Injuries In Patients Undergoing Ventricular Assist Device And Total Artificial Heart Surgeries: An Eight-Year Retrospective Cohort Study

Christopher Brindle
BACKGROUND Rates of end-stage heart failure patients who undergo VAD or TAH surgeries are increasing. The  risk factors for pressure injuries (PI) development remain unexplored. This dissertation research investigated the incidence and risk factors of PI development in VAD-TAH surgery.            METHODS All VAD-TAH surgeries performed between 2010-2018   in a large academic health system were studied. PI are reported by case incidence, patient incidence and incidence density for each of the respective 1000 patient days during the study period. Statistics on four different VAD-TAH devices are assessed, with variables significant in bivariate analysis entered into a stepwise logistic regression model to identify significant predictors of PI. RESULTS The sample for investigation included 292 independent VAD-TAH surgical cases  in 265 patients. Thirty two  patients developed 45 PI. The incidence of PI per all surgical cases was 11% (32/292), with PI incidence per patient of 12% (32/265). Incidence density was found to be (10/1000) 1% for 2010-2012, (12/1000) 1.2% for 2013-2015, and (10/920) 1.1% for 2016-2018 respectively. Logistic regression revealed significant predictor variables for pressure injury were: age, mechanical ventilation time and preoperative Braden Risk Assessment score. The mean time to PI was 23 days after admission and over 14 days after surgery, indicating a low rate of intraoperative and ICU associated PI. CONCLUSIONS Incidence of PI was lower than anticipated given historical incidence in non-device patients. Potential mechanisms by which these patients were protected from PI are discussed. Prospective studies to further investigate significant risk factors and effective prevention measures are warranted.

Sponsor

Sponsor name
Not applicable. Research completed at Virginia Commonwealth University and poster would be on VCU background. No financial support was provided for poster.

References

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Not applicable: Dissertation research

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