PP342
PRESSURE INJURY PROGRESSION IN ICU PATIENTS: ROLE OF ILLNESS SEVERITY VERSUS EARLY NUTRITIONAL TARGETS
A. O. Taş1, K. Inci1,*, S. Taş2, G. Aygencel1, N. Boyacı Dündar1, O. T. Şahin1, M. Türkoğlu1
1Department of Internal Medicine, Division of Critical Care, 2Department of Internal Medicine, Gazi University Faculty of Medicine, Ankara, Türkiye
Rationale: Adequate energy and protein delivery are essential in critical care, yet their impact on pressure injury progression (PI) remains unclear. As early deficits may impair tissue integrity and wound healing, we evaluated the association between early nutritional target achievement and PI progression (PIP).
Methods: This retrospective cohort included adult tertiary medical ICU patients (June 2020–June 2023) from Gazi University Hospital with ICU stay ≥7 days and complete nutritional and PI data. Energy and protein requirements were calculated per ESPEN guidelines. Nutritional variables were expressed as mean daily delivery over the first 7 days. Target achievement was defined as ≥70% of calculated requirements. PIP was defined as new or worsening PI per NPIAP classification(2). Logistic regression identified factors associated with PIP and ICU mortality.
Results: A total of 252 patients were included; ICU mortality was 47%. At admission, 58% had PIs, and 50% of the patients developed PIP. Energy delivery was similar between PIP+ and PIP- groups (13 vs 13 kcal/kg/day, p=0.56). Protein delivery was lower in the PIP+ group (0.66 vs 0.81 g/kg/day, p<0.01), and protein target achievement was less frequent than PIP- group (23% vs 33%, p<0.01), whereas energy target achievement was comparable (35% vs 36%, p=0.41). In multivariable analysis, age, APACHE II score, shock at admission, and malnutrition risk were independently associated with PIP (all p<0.01), whereas nutritional target achievement was not.
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Conclusion: These findings suggest that early nutritional adequacy alone may be insufficient to modify pressure injury risk, particularly in patients with poor physiological reserve or severe critical illness.
References: 1-Edsberg LE, et al. Revised National Pressure Ulcer Advisory Panel Pressure Injury Staging System: Revised Pressure Injury Staging System. J Wound Ostomy Continence Nurs. 2016 Nov/Dec;43(6):585-597.
Disclosure of Interest: None declared