Lesões de pele em idosos internados em unidades de terapia intensiva: uma visão interdisciplinar

Abstract

Among the numerous physiological changes that occur during aging, changes in the integumentary system stand out, making the skin more friable to the appearance of lesions, a factor that is exacerbated in the scenario of hospitalization in intensive care. In view of the vulnerability of critical elderly people to skin lesions, studies on the subject are necessary. We sought to analyze the prevalence and factors associated with skin lesions in elderly patients admitted to intensive care units of a university hospital. This is an observational cross- sectional study developed in two Adult Intensive Care Units of a teaching hospital in Campos Gerais, Ponta Grossa, Paraná, from July 2017 to July 2019. Skin inspection and sociodemographic and clinical questionnaire of hospitalized elderly were developed. It is noteworthy that the research is part of a larger project, approved by the Research Ethics Committee with human beings under opinion nº 2.012.327 and CAAE nº 66782217.9.0000.5689. There was an association between the variables with the chi-square test, confidence interval of 95%, as well as OR calculation. Subsequently, variables with p<0.20 were selected in the bivariate analysis and based on these, building a predictive model. Of the 133 elderly, 36.8% had pressure injury associated with enteral diet and thin skin thickness, 14.3% with medical adhesive injury associated with enteral feeding, smooth skin texture and presence of dermatitis associated with incontinence, which was observed in 10.5% and was associated with a greater number of injuries, as well as friction injury verified in 10.5%, associated with decreased turgor and obesity. From the predictive model, it was found that the use of enteral diet increases the chance of having a pressure injury by seven times, as well as the factors: not being married (OR=2.5) presenting secondary injury (OR=7.8) and high risk for developing pressure injuries, (OR=8.7). Elderly people with reduced skin turgor are five times more likely to develop dermatitis and pruritus have 10.2 chances of acquiring this condition. Potentially modifiable variables related to injuries were evidenced, requiring theoretical and practical knowledge for prevention. In view of this demand, preventive measures against skin lesions were listed, through an interdisciplinary protocol.