Increased pressure sore risk has a worse diagnosis in hospitalized Stroke patients           /             Maior risco de lesão por pressão tem pior prognóstico na hospitalização de pacientes com Acidente Vascular Cerebral

Patricia Leticia  Beche; Mairin  Schott; Clandio  Timm Marques; Sérgio Roberto  Mortari; Elisângela Colpo

doi:10.9789/2175-5361.rpcfo.v14.11623

Authors

Patricia Leticia Beche Franciscan University https://orcid.org/0000-0002-0440-944X
Mairin Schott Franciscan University https://orcid.org/0000-0002-4248-5240
Clandio Timm Marques Franciscan University https://orcid.org/0000-0002-9984-0100
Sérgio Roberto Mortari Franciscan University https://orcid.org/0000-0002-1166-3980
Elisângela Colpo Franciscan University https://orcid.org/0000-0002-3886-0765

DOI:

https://doi.org/10.9789/2175-5361.rpcfo.v14.11623

Keywords:

Human, Biomarkers, Mortality, Nervous System Diseases

Abstract

Objective: To associate pressure sore risk with the severity of hospitalized stroke patients. Methodology: Transverse study with 64 hospitalized stroke patients. Sociodemographic data were obtained from the medical information form; anthropometrics, pressure sore risk (via Braden Scale) and plasma vitamin C were assessed. Results: sample predominantly elderly with ischemic stroke; 48.4% presented a high risk of pressure sore development. Patients with higher pressure sore risk had increased mortality (p<0.001) and greater leukocytosis (p=0.028) and lymphopenia (p<0.001) than those with lower pressure sore risk. Nonetheless, vitamin C levels did not differ with regard to the pressure sore risk. There were no significant differences in nutritional status as regards pressure sore risk. Conclusion: Patients with high risk for developing pressure sore present leukocytosis, lymphopenia and increased mortality risk.

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Author Biographies

Patricia Leticia Beche, Franciscan University

BA in Nutrition by the Universidade Franciscana – UFN. Santa Maria- Rio Grande do Sul- Brasil.

Mairin Schott, Franciscan University

Nutricionist, and MD in Health Science and Life from Universidade Franciscana – UFN. Santa Maria- Rio Grande do Sul- Brasil.

Clandio Timm Marques, Franciscan University

PhD in Statistics and Operational Research by University of Lisboa, Portugal. Professor at the Universidade Franciscana - UFN. Santa Maria- Rio Grande do Sul- Brasil.

Sérgio Roberto Mortari, Franciscan University

PhD in Chemistry by Universidade Católica do Rio de Janeiro. Professor at the Universidade Franciscana – UFN. Santa Maria- Rio Grande do Sul- Brasil.

Elisângela Colpo, Franciscan University

PhD in Toxicological Biochemistry of the Universidade Federal de Santa Maria. Professor at the Universidade Franciscana - UFN. Santa Maria- Rio Grande do Sul- Brasil.

References

Ministério da Saúde (BR). O que é o AVC? [Internet]. 2021 [acesso em 18 de maio 2021]. Disponível em:https://www.gov.br/saude/pt-br/assuntos/saude-de-a-a-z-1/a/avc-o-que-e-causas-sintomas-tratamentos-diagnostico-e-prevencao.

World Health Organization (WHO). Stroke, cerebrovascular accident. [Internet]. 2021. [cited 2021 mai 20]. Available from: http://www.emro.who.int/health-topics/stroke-cerebrovascular-accident/index.html.

Cox J, Rasmussen L. Enteral nutrition in the prevention and treatment of pressure ulcers in adult critical care patients. Crit Care Nurse. [Internet]. 2014 [cited 2021 mai 18];34(6). Available from: https://doi.org/10.4037/ccn2014950.

Lee SY, Chou CL, Hsu SPC, Shih CC, Yeh CC, Hung CJ, et al. Outcomes after Stroke in Patients with Previous Pressure Ulcer: A Nationwide Matched Retrospective Cohort Study. J Stroke Cerebrovasc Dis [Internet]. 2016 [cited 2021 mai 5];25(1). Available from: http://dx.doi.org/10.1016/j.jstrokecerebrovasdis.2015.09.022.

Sirimaharaj W, Charoenvicha C. Pressure Ulcers: Risk Stratification and Prognostic Factors That Promote Recurrence After Reconstructive Surgery. Int J Low Extrem Wounds. [Internet]. 2018 [cited 2021 fev 8];17(2). Available from: https://doi.org/10.1177/1534734618779858.

Ayello EA, Braden B. How and Why to Do Pressure Ulcer Risk Assessment. Advances. [Internet] 2002 [cited 2021 jun 22];15(3). Available from: https://pubmed.ncbi.nlm.nih.gov/12055446/.

Chumlea WC, Guo S, Roche AI, Steinbaugh ML. Prediction of body weight for non-ambulatory elderly from anthropometry. J. Am. Diet Assoc. [Internet] 1988 [cited 2021 jun 10]; 88(5). Available from: https://pubmed.ncbi.nlm.nih.gov/3367012/.

Gray DS, Crider JB, Kelley C, Dickinson L. Accuracy of recumbent height measurement. J. Parenter. Enteral. Nutr. [Internet] 1985 [cited 2021 fev 2]; 9(6). Available from: https://pubmed.ncbi.nlm.nih.gov/4068195/.

Vellas B, Guigoz Y, Garry PJ, Nourhashemi F, Bennahum S, Lauque S, Albarede JL. The mini nutritional assessment; a practical assessment tool for grading the nutritional status of elderly patients. In: Guigoz SC, et al. The Mini Nutritional Assessment: MNA, Facts and Research in Gerontology [Internet] 1999 [cited 2021 mai 18]; 15(2). Available from: https://doi.org/10.1111/imj.14030.

World Health Organization. Physical status the use and interpretation of anthropometrics. Report of a World Health Organization. Expert Committee. WHO. Technical Report Series [Internet] 1995 [cited 2021 mar 22]; 854. Available from: https://apps.who.int/iris/handle/10665/37003.

Lipschitz DA. Screening for nutritional status in the elderly. Prim. Care [Internet] 1994 [cited 2021 mai 15]; 21(1). Available from: https://doi.org/10.1016/S0095-4543(21)00452-8.

Paranhos WY, Santos VLCG. Avaliação de risco para ulceras de pressão por meio da Escala de Braden, na lingua portuguesa. Rev Esc Enfermagem USP. [Internet]. 1999 [acesso em 20 de agosto 2021]; 33. Disponível em: http://www.ee.usp.br/reeusp/upload/pdf/799.pdf.

Cuppari L. Nutrição Clínica no adulto. 2a ed. Barueri (SP): Editora Manole, 2005.

World Health Organization. Haemoglobin concentrations for the diagnosis of anaemia and assessment of severity. Vitamin and Mineral Nutrition Information System. Geneva [Internet] 2011 [cited 2021 jun 21]. Available from: https://www.who.int/vmnis/indicators/haemoglobin.pdf.

Lameu EB, et al. Adductor pollicis muscle: a new anthropometric parameter. Rev Hosp Clín Fac Med S Paulo, [Internet] 2004 [cited 2021 mai 10]; 59(2). Available from: https://doi.org/10.1590/S0041-87812004000200002.

Rodrigues CAO, Silva PLN da, Miranda FB, Galvão APFC, Martins AG e, Araújo DD de. Risco de lesão por pressão em pacientes domiciliares: prevalência e fatores associados. [Internet] 2020 [acesso em 7 de setembro 2021]; 08(43). Disponível em: http://revistas.mpmcomunicacao.com.br/index.php/revistaferidas/article/view/1360/1588.

Catania AS, Barros CR de, Ferreira SRG. Vitaminas e minerais com propriedades antioxidantes e risco cardiometabólico: controvérsias e perspectivas. Arq Bras Endocrinol Metabol. [Internet] 2009 [acesso em 6 de agosto 2021];53(5). Disponível em: https://www.scielo.br/j/abem/a/vMDc3NMLwdSgZ3zcmk85rDP/?lang=pt.

Gey KF, Stahelin HB, Eichholzer M. Poor plasma status of carotene and vitamin C is associated with higher mortality from ischemic heart disease and stroke Basel Prospective Study. Clin Investig. [Internet] 1993 [cited 2021 jul 7]; 71(1). Available from: https://pubmed.ncbi.nlm.nih.gov/8453256/.

Chambial S, Dwivedi S, Shukla KK, John PJ, Sharma P. Vitamin C in disease prevention and cure: An overview. Indian J Clin Biochem. [Internet] 2013 [cited 2021 mar 5];28(4). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3783921/pdf/12291_2013_Article_375.pdf.

Riandini R, Emaliawati E, Mirwanti R. Prevalence, Prevention, and Wound Care of Pressure Injury in Stroke Patients in the Neurology Ward. Belitung Nurs J.[Internet] 2018 [cited 2021 Fev 30]; 4(6). Available from: https://doi.org/10.33546/bnj.555.

Okatiranti, Sitorus RE, Tsuawabeh D. Risiko Terjadinya Dekubitus Berdasarkan Tingkat Ketergantungan Pasien di Ruang Perawatan Neurologi The Risk of Decubitus Incidence Based on Patients ’ Dependency Levei in Neurological Ward. J Keperawatan Padjadjaran. [Internet] 2013 [cited 2021 mar 5];1(3). Available from: https://doi.org/10.24198/jkp.v1i3.66

Teller P, White TK. The Physiology of Wound Healing: Injury Through Maturation. Surg Clin North Am. [Internet] 2009 [cited 2021 mar 8];89(3). Available from: https://pubmed.ncbi.nlm.nih.gov/19465199/

Rocha S de S. Análise da presença e estadiamento da lesão por pressão em pacientes hospitalizados e a relação com seus respectivos achados laboratoriais. Cuité (Brasil): Univ Fed Camp Gd; 2018. [acesso em 9 de julho 2021]. Disponível em: http://dspace.sti.ufcg.edu.br:8080/jspui/handle/riufcg/6961

Jaffe R, Mami J. Rethink health: inflammation is actually repair deficit: using physiology first to achieve better outcomes. [Internet] 2013. [cited 2021 Fev 10]. Available from: https://www.thefreelibrary.com/Rethink health: inflammation is actually repair deficit: using...-a0335934820.

Campos SF, Chagas ÂCP, Costa ABP, França RE de M, Jansen AK. Fatores associados ao desenvolvimento de úlceras de pressão: o impacto da nutrição. Rev Nutr. [Internet] 2010 [acesso em 2 de agosto 2021];23(5). Disponível em: https://www.scielo.br/j/rn/a/vRqnVBZ6MFWp95yM7X3k7wJ/?lang=pt.

Duarte ACG. Avaliação nutricional: aspectos clínicos e laboratoriais. São Paulo: Atheneu, 2007.

Fernandes M das GM, Costa KN de FM, dos Santos SR, Pereira MA, Oliveira DST, Brito S da S. Risco para úlcera por pressão em idosos hospitalizados: Aplicação da Escala de Waterlow. Rev Enferm. [Internet] 2012 [acesso em 10 julho 2021];20(1). Disponível em: https://www.e-publicacoes.uerj.br/index.php/enfermagemuerj/article/view/3977/2759.

Oliveira DR, Frangella VS. Músculo adutor do polegar e força de preensão palmar: potenciais métodos de avaliação nutricional em pacientes ambulatoriais com acidente vascular encefálico. Einstein (São Paulo). 2010 [cited 2021 mar 15];8(4). Disponível em: https://www.scielo.br/j/eins/a/xj877Z5zxFP7GhfgdTbSsyf/?format=pdf&lang=pt.

Schott M, Dachi L, Cassol MC, Brondani JE, Colpo E. Risk of pressure ulcer in hospitalized patients after stroke : relation of nutritional factors and of morbidity. Clin Pract. 2018 [acesso 22 de maio 2021];15(1). Available from: https://www.openaccessjournals.com/articles/risk-of-pressure-ulcer-in-hospitalized-patients-after-stroke-relation-of-nutritional-factors-and-of-morbidity-12300.html.

Serpa LF, Santos VLCDG. Desnutrição como fator de risco para o desenvolvimento de úlceras por pressão. Acta Paul Enferm. 2008 [acesso em 22 junho 2021]; 21(2). Disponível em: https://www.scielo.br/j/ape/a/sqRrFGXvF9RvG9N4MKYZvjH/?format=pdf&lang=pt.