Pressure injury protection strategies are needed in the process of interhospital transport: The findings of a retrospective cohort study

Abstract

Abstract Background Pressure injuries (PIs) have implications for intensive care unit (ICU) patients. Interhospital transport (IHT) is important to obtain high-quality medical care, but it may complicate PIs. Objective To determine the necessity of adopting a PI protective strategy during IHT. Design A retrospective cohort study. Participants Adult patients admitted to the ICU of Qilu Hospital of Shandong University from January 2018 to December 2019 were included. Methods Patients who underwent IHT were the IHT group, and those who were admitted directly were the non-transported (NT) group. The Braden score was used to assess the risk of PI. Results The prevalence of PIs was not different between the two groups. The risk factors for PI, such as unconsciousness, a high proportion of mechanical ventilation (MV) and low hemoglobin level, were more obvious in IHT patients, but younger age, higher body mass index and lower vasoactive drug (VD) use were protective factors. The Braden score was lower in the IHT group, and in both groups decreased in the first 4 days and recovered in the following 3 days, and the difference disappeared at the end of ICU care, but the price is that IHT consumes more resources. Even in the weighted population created by applying inverse probability weighting, the difference persisted. In subgroup analysis, the Braden score of patients without MV or VD use showed the above characteristics, but not with MV or/and VD use patients. The Braden score difference between ICU-sourced IHT patients and NT patients still existed at the end of ICU care. Conclusions IHT brings more challenges to the prevention of PI in critically ill patients. It is very necessary to adopt protective strategies in the process of transportation, especially to transport patients between ICU. Implications for Clinical Practice PI protection measures should be adopted in the process of inter-hospital transport, especially in the transfer of patients between ICU.