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Survenue ou aggravation des escarres selon le temps de passage aux urgences chez les sujets âgés, dépendants ou paralysés : une étude observationnelle prospective
Mémoire de Master / Thèse d'exercice   Open Access

Survenue ou aggravation des escarres selon le temps de passage aux urgences chez les sujets âgés, dépendants ou paralysés : une étude observationnelle prospective

Marie Van Overstraeten
Masters , Université de Montpellier
13/09/2024

Résumé

Elderly Emergency department Time of stay Escarres -- Chez la personne âgée Personnes âgées dépendantes Délais d'attente (médecine) Hôpitaux -- Services des urgences Évolution de la maladie Pressure ulcer
In the last decades, there has been an increased use of french emergency departments. At the same time the population is aging, increasing the use of emergency departments by elderly people. In the emergency department, patients have to stay several hours on a stretcher. People over 75 are more fragile and present more risk of pressure ulcer. The occurrence of pressure ulcers in emergency departments, especially in elderly people has been poorly studied. This study aims to analyse the appearance and worsening of pressure ulcers among people over 75 according to time of stay in the emergency department. Methodology: we conducted an observational prospective study in the emergency department of CHU de Montpellier. People over 75, or people with GIR under 3, or people with significant paralysis, or people with pressure ulcers arriving at the emergency department were included. Skin was observed arriving and leaving the emergency department. The grade of pressure ulcer was determined by the National Pressure Ulcer Advisory Panel. The difference between skin condition at arrival and departure was studied. The primary outcome was the worsening of NPUAP scale according to the time of stay in the emergency department. Results: 277 patients were included ; the primary outcome was analysed among 128 (46,2%) patients. Patients with occurring or worsening of pressure ulcer were presenting a median time of stay of 540 [462; 611] minutes versus 457 [353; 582] minutes for people with stable skin condition (p < 0,05). Odds-ratio was 1.02 [0.998; 1.05]. Conclusion: patients who stay for a longer period in the emergency department were presenting more appearance or worsening of pressure ulcer. Preventing pressure ulcers as soon as patients arrive is crucial.

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