Characteristics and influencing factors of oral mucosal pressure injury in ICU elderly patients with tracheal intubation in ICU
WANG Bao-qin
JIANG Xue-juan
SHI Guang-ling
LI Bei
Abstract：Objective To explore the characteristics of oral mucosal pressure injury (PI) in elderly patients with tracheal intubation in intensive care unit (ICU) and analyze its influencing factors.Methods 197 ICU elderly patients with oral tracheal intubation in Brain Hospital Affiliated to Nanjing Medical University were selected as the research subjects from January 2019 to December 2023.The occurrence of oral mucosal PI was counted analyzed and its clinical characteristics were analyzed.Oral mucus samples were collected to calculate the oral bacterial count.The influencing factors of oral mucosal pressure injury were analyzed by multi-factor Logistic regression.Results Among the 197 ICU patients with tracheal intubation,29 cases had occurred oral mucosal PI,with an incidence rate of 14.72％.The occurrence time of oral mucosal PI was 36-302 h after tracheal intubation placement,and the median occurrence time was 103 h after intubation placement.There were 43 injuries,most of which occurred in the lower lip[37.21％ (16/43)],followed by the palate[20.93％ (9/43)].PI staging was mainly stage 2,accounting for 51.16％.The tracheal intubation placement time,anticoagulant use rate and oral Pseudomonas aeruginosa count in patients with oral mucosa PI were higher than those of patients without oral mucosal PI while the Glasgow Coma Score (GCS) and serum albumin level were lower than those of patients without oral mucosal PI (P<0.05).Long-term indwelling tracheal intubation (OR=2.321),anticoagulant use (OR=1.943),low GCS score (OR=2.901),low serum albumin (OR=3.108) and high count of oral Pseudomonas aeruginosa (OR=2.649) were all risk factors for oral mucosal PI in patients with oral tracheal intubation (P<0.05).Conclusion The incidence rate of oral mucosal PI in ICU elderly patients with tracheal intubation is higher,and its occurrence is related to a variety of factors such as tracheal intubation placement time,anticoagulant drug,GCS score,serum albumin level and oral Pseudomonas aeruginosa count.Early prevention and treatment of these risk factors may help to reduce the risk of PI in oral mucosa in ICU.
Keywords：Intensive care unitTracheal intubationOral mucosaPressure injuryInfluencing factors
Publication Date：2024-07-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 200-204,229 )