Association between pressure ulcer and 28-day mortality in septic patients: a retrospective study based on the MIMIC-IV database
Yan Zhu, Johan van der Lei, Jie Zou, Xuefeng Liu, Wenfang Li, Feng Cao
Abstract
BACKGROUND: Pressure ulcer is a significant issue that cannot be overlooked in septic patients. This study aims to explore the impact of pressure ulcers on the 28 day mortality rate of septic patients. METHODS: The data for this study were obtained from the MIMIC-IV v3.0 database. Univariate and multivariate analysis methods were employed to conduct an in-depth exploration of the 28 day mortality rate of septic patients. Kaplan-Meier survival curves were plotted to verify the influence of pressure ulcer on the 28 day mortality rate of septic patients. In addition, subgroup analysis was carried out to reveal the relationship between pressure ulcer and other confounding factors. RESULTS: Among the 20,280 patients included in the MIMIC-IV cohort, 880 had pressure ulcers. Both the results of univariate and multivariate analyses showed that pressure ulcers were a significant influencing factor for the 28 day mortality rate of septic patients (p = 0.002). The survival curves indicated that the 28 day mortality rate of septic patients with pressure ulcers was significantly higher than that of septic patients without pressure ulcers. The Cox proportional hazards model analysis demonstrated that septic patients with pressure ulcers had a 28 day mortality hazard ratio of 1.30 compared with septic patients without pressure ulcers. The results of subgroup analysis suggested that more attention should be paid to the prevention of pressure ulcers in patients younger than 65 years old, male patients, patients with a SOFA score greater than 3, and patients with comorbid diabetes or renal diseases . CONCLUSION: Pressure ulcers may independently associate with increased mortality in septic patients.