Oral pressure injuries in patients hospitalized during the COVID-19 pandemic and associated factors: a cross-sectional study

Lesões por pressão em pacientes hospitalizados durante a pandemia de COVID-19 e fatores associados: estudo transversal

Autores

  • Nailde Melo Santos Universidade CEUMA
  • Veridiana Resende Novais Simamoto Universidade Federal de Uberlândia
  • Meire Coelho Ferreira Universidade CEUMA

Palavras-chave:

Patients;, COVID-19;, Intensive Care Units, Pressure ulcer;, Mouth.

Resumo

Background: Patients critically ill with coronavirus disease (COVID) who are admitted to intensive care unit (ICU) are susceptible to a vast number of complications that life-threatening. Objective: To investigate the frequency of oral cavity pressure injuries (OPI) in adult patients hospitalized for COVID in an ICU and associated factors. Method: A retrospective cross-sectional study was carried out using electronic medical records of patients admitted to the ICU, whether due to COVID or other conditions (NO COVID), in São Luís, Maranhão, Brazil. Demographic data, comorbidities, length of stay, intubation time, O2 saturation, use of vasoactive drugs, and hospitalization (due to COVID or NO COVID), and OPI were extracted from the medical records. The data was subjected to descriptive statistics, Chi-square test, Mann-Whitney test and Poisson regression (α=5%). Results: The frequency of OPI in patients hospitalized for COVID was 38.5%. The most frequent comorbidities in both groups were hypertension and diabetes mellitus. The use of vasoactive drugs and OPI was more frequent in the NO COVID group (p=0.010; p=0.021). The average length of stay was significantly longer for the COVID group (15.8 days) compared to the NO COVID group (10.6 days) (p=0.025). The average length of hospitalization and intubation was significantly higher for the group with OPI (p=0.003; p<0.001). In the adjusted regression analysis, the length of intubation was the factor suggestive of explaining to OPI (PR=2.547; CI=1.423-4.558). Conclusion: Longer hospitalization and intubation times were responsible for pressure injuries in the oral cavity, demonstrating the need for continuous assessment of hospitalized patients in order to prevent the establishment of these injuries.

Downloads

Não há dados estatísticos.

Biografia do Autor

Nailde Melo Santos, Universidade CEUMA

Especialista em UTI e Tecnologias Educacionais, Mestre em Enfermagem (UFMA), Doutoranda em Odontologia - UNICEUMA, Docente do Curso de Enfermagem - UNICEUMA.

Veridiana Resende Novais Simamoto, Universidade Federal de Uberlândia

Mestre em Odontologia pela Universidade Federal de Uberlândia (UFU), Doutora em Materiais Dentários pela Faculdade de Odontologia da Universidade Estadual de Campinas (UNICAMP).

Meire Coelho Ferreira, Universidade CEUMA

Especialista em Odontopediatria (UNIVALE), Mestre e Doutora em Odontologia (área de concentração - Odontopediatria - UFSC), Pós- Doutora em Epidemiologia (UFMG e UFVJM). 

Referências

AMINI, M. et al. Factors affecting the incidence and prevalence of pressure ulcers in COVID-19 patients admitted with a Braden scale below 14 in the intensive care unit: retrospective cohort study. International Wound Journal, Oxford, v. 19, n. 8, p. 2039-2054, 2022.

AVELINO, J. et al. Oral manifestations and COVID-19: a literature review. Research Society and Development, Vargem Grande Paulista, v. 11, n. 13, p. e42111334976, 2022.

BARON, M. V. et al. Does COVID-19 infection increase the risk of pressure injury in critically ill patients?: a narrative review. Medicine, Baltimore, v. 101, p. e29058, 2022.

BORGHARDT, A. T. et al. Pressure ulcers in critically ill patients: incidence and associated factors. Brazilian Journal of Nursing, Brasília, DF, v. 69, n. 3, p. 460-467, 2016.

COLLING, M. E.; KANTHI, Y. COVID-19–associated coagulopathy: an exploration of mechanisms. Vascular Medicine, London, v. 25, n. 5, p. 471-478, 2020.

COX, J.; SCHALLOM, M.; JUNG, C. Identifying risk factors for pressure injury in adult critical care patients. American Journal of Critical Care, Aliso Viejo Ca, v. 29, n. 3, p. 204-213, 2020.

DALLI, Ö. E.; CEYLAN, İ.; GIRGIN, N. K. Incidence, characteristics and risk factors of medical device-related pressure injuries: an observational cohort study. Intensive & Critical Care Nursing, Edinburgh, v. 69, p. 103180, 2022.

DAMMASSA, V. et al. Endogenous catecholamine release in COVID-19 related acute respiratory distress syndrome: link between enhanced sympathetic stimulation, cardiac dysfunction and outcome. Journal of Clinical Medicine, Basel, v. 12, n. 4, p. 1557, 2023.

EDSBERG, L. E. et al. Revised national pressure ulcer advisory panel pressure injury staging system: revised pressure injury staging system. Journal of Wound Ostomy & Continence Nursing, St. Louis, v. 43, n. 6, p. 585-597, 2016.

ELRAYESS, M. A. et al. Soluble ACE2 and angiotensin II levels are modulated in hypertensive COVID-19 patients treated with different antihypertension drugs. Blood Pressure, Oslo, v. 31, n. 1, p. 80-90, 2022.

FERREIRA, M. D. et al. COVID-19 hospitalized patients and oral changes: a case-control study. Clinical Oral Investigations, Berlin, v. 27, n. 8, p. 4481-4491, 2023.

GUPTA, A. et al. Estimating the prevalence of oral manifestations in COVID-19 patients: a systematic review. Osong Public Health and Research Perspectives, Yeonje-ri, v. 14, n. 5, p. 388-417, 2023.

GUAN, W. J. et al. Clinical characteristics of coronavirus disease 2019 in China. The New England Journal of Medicine, New York, v. 382, p. 1708-1720, 2020.

HOCKOVÁ, B. et al. Oral complications of ICU patients with COVID-19: case-series and review of two hundred ten cases. Journal of Clinical Medicine, Basel, v. 10, n. 4, p. 581, 2021.

HÜPSCH-MARZEC, H. et al. The spectrum of non-characteristic oral manifestations in COVID-19: a scoping brief commentary. Medycyna Pracy, Warszawa, v. 72, n. 6, p. 685-692, 2021.

KOT, W. Y. et al. A reflection on COVID-19 and oral mucosal lesion: a systematic review. Frontiers in Oral Health, Lausanne, v. 4, p. 4:1322458, 2023.

LAAKE, J. H. et al. Characteristics, management and survival of ICU patients with coronavirus disease-19 in Norway, March-June 2020. A prospective observational study. Acta Anaesthesiologica Scandinavica, Oxford, v. 65, n. 5, p. 618-628, 2021.

LINDHOLZ, M. et al. Mobilisation of critically ill patients receiving norepinephrine: a retrospective cohort study. Critical Care, [S. l.], v. 26, n. 1, p. 362, 2022.

McLARNEY, B. D. et al. Predictors of COVID-19 disease severity augment the Braden scale in the prediction of pressure ulcer development among COVID-19–positive intensive care unit patients: a case-control study. Journal of the American Academy of Dermatology, St. Louis, v. 87, n. 3, p. 711-714, 2022.

MERVIS, J. S.; PHILLIPS, T. J. Pressure ulcers: pathophysiology, epidemiology, risk factors, and presentation. Journal of the American Academy of Dermatology, St. Louis, v. 81, n. 4, p. 881-890, 2019.

MONTGOMERY, A. P. et al. Modeling patient risk for hospital-acquired pressure injuries during COVID-19: a retrospective study. Journal of Nursing Care Quality, Hagerstown, v. 37, n. 2, p. 162-167, 2022.

NIETO-GARCÍA, L. et al. Are there differences between COVID-19 and non–COVID-19 inpatient pressure injuries? Experiences in internal medicine units. PloS One, San Francisco, v. 17, n. 2, p. e0263900, 2022.

NUNO-GONZALES, A. et al. Prevalence of mucocutaneous manifestations in 666 patients with COVID‐19 in a field hospital in Spain: oral and palmoplantar findings. The British Journal of Dermatology, Oxford, v. 184, n. 1, p. 184-185, 2020.

POKORNÁ, A. et al. How the COVID-19 pandemic influences the prevalence of pressure injuries in the Czech Republic: a nationwide analysis of a health registry in 2020. Journal of Tissue Viability, Salisbury, v. 31, n. 3, p. 424-430, 2022.

RAMALHO, A. O. et al. Reflections on recommendations for the prevention of pressure injuries during the COVID-19 pandemic. Estima, São Paulo, v. 18, p. e2520, 2020.

SALEH, M. Y. N.; IBRAHIM, E. I. M. Prevalence, severity, and characteristics of medical device related pressure injuries in adult intensive care patients: a prospective observational study. International Wound Journal, Oxford, v. 20, n. 1, p. 109-119, 2023.

SHEARER, S. C. et al. Facial pressure injuries from prone positioning in the COVID-19 era. Laryngoscope, St. Louis, v. 131, n. 7, p. E2139-E2142, 2021.

TEIXEIRA-VAZ, A. et al. The PRINCOVID retrospective study: a predictive model of pressure injuries for critical COVID-19 patients. American Journal of Physical Medicine & Rehabilitation, Baltimore, v. 102, n. 8, p. 707-714, 2023.

VON ELM, E. et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Journal of Clinical Epidemiology, New York, v. 61, n. 4, p. 344-349, 2008.

YIĞITOĞLU, E. T.; AYDOĞAN, S. Determination of medical device-related pressure injury in COVID-19 patients: a prospective descriptive study. Journal of Tissue Viability, Salisbury, v. 32, n. 1, p. 74-78, 2023.

Downloads

Publicado

2024-02-26

Edição

Seção

Articles