Sepsis episodes caused by pressure injuries in critical illness: a retrospective observational cohort study

Wound Manag Prev. 2023 Nov;69(4):4-9. doi: 10.25270/wmp.22093.

Abstract

Background: Critically-ill patients (CIPs) with pressure injuries (PIs) may develop bloodstream infections (BSIs).

Purpose: To identify predisposing factors and discuss diagnosis and management of sepsis-related PIs in CIPs.

Methods: The records of CIPs in the intensive care unit (ICU) between January 1, 2014, and January 1, 2020, with PI with sepsis-diagnoses and with different site cultures that were positive concurrent with bloodstream-cultures were retrospectively reviewed.

Results: Ninety-one sepsis episodes were included in the study. Low albumin level (U = 382.00, P = .006), renal failure (odds ratio [OR], 0.108 [95% CI, 0.015-0.783]; P = .025), and length of ICU stay (U = 130.00, P < .001) were identified as risk factors of BSIs due to PIs. The probability of BSI during a sepsis episode was lower in CIPs with PIs with higher C-reactive protein levels (U = 233.00, P < .001) and whose injury resulted from trauma or surgery (OR, 0.101 [95% CI, 0.016-0.626]; P = .014). The mortality was higher in CIPs with PI-induced BSIs (OR, 0.051 [95% CI, 0.008-0.309]; P = .001).

Conclusions: Pressure injury-induced sepsis was associated with a high risk of 28-day mortality. The findings suggest that CIPs with PI are at increased risk of BSIs if they have low albumin levels, renal-failure, and prolonged ICU stay during sepsis episodes.

Publication types

  • Observational Study

MeSH terms

  • Albumins
  • Critical Illness
  • Humans
  • Pressure Ulcer* / complications
  • Pressure Ulcer* / etiology
  • Retrospective Studies
  • Sepsis* / complications

Substances

  • Albumins