Investigating the severity and factors influencing the occurrence of pressure ulcers in hospitalized cerebrovascular accident patients: a retrospective cohort study

Patients with cerebrovascular accidents (CVA) are at risk of developing PUs due to sensory, motor and cognitive deficits following the disease. Therefore, the aim of the present study was to investigate the severity and factors affecting the occurrence of PUs in patients with CVA. The present study was a retrospective cohort study. The data of this research was extracted from the registry system of Imam Reza Hospital located in the west of Iran. 217 patients with CVA with Braden score below 14 or with PU were included in the study. In order to investigate the relationship between independent variables and wound stage in univariate regression model, logistic regression was used, and the results were reported as odds ratio (OR). Data were analyzed with Stata statistical software version 15 and Excel 2016 software. Out of 217 CVA patients hospitalized, 180 had pressure ulcers. In total, 465 PUs were diagnosed in 180 patients in different areas. The average age of patients was (SD=61±8.78) years. 65 patients suffered only one wound, 38 patients experienced two wounds, and 37 patients experienced three wounds. The highest number of PUs was with 201 cases of stage I, followed by 180 cases of stage II. Stage IV with 2 cases was the least PU cases. Patients with a Braden score of 10-12 were 3.89 times more likely than patients with a Braden score greater than 14, and patients with a Braden score of 6-9 were diagnosed with PUS 6.67 times more than those with a Braden score greater than 14. Regarding the site of PUs, the sacrum and then the buttock were the most common sites of PU, which were observed in 65.56% and 29.49% of patients, respectively. The highest number of stage I was related to the sacrum area. The sacrum was the most common site of PU occurrence and the highest number of PUs was related to stage I. Age, fecal incontinence, hemoglobin levels and Braden’s score have been among the factors affecting PUs in patients with CVA.