Predictive value of pressure ulcer risk for obstructive coronary artery disease

Yao Wang, Ran Chen, Jie Ding, Lu Yang, Jiaojiao Chen, Baotao Huang, Yao Wang, Ran Chen, Jie Ding, Lu Yang, Jiaojiao Chen, Baotao Huang

Abstract

Aim: To investigate the relationship between pressure ulcers risk and severity of obstructive coronary artery disease (CAD) by invasive coronary angiography.

Design: Cross-sectional study.

Methods: A total of 193 consecutive patients with underlying pressure ulcers risk who underwent invasive coronary angiography were enrolled. Subjects were divided into three groups according to severity of coronary artery stenosis. Pressure ulcers risk score, fall risk score, self-care ability score and cardiovascular risk factors were compared among the three groups. Multivariate regression analysis and receiver operating curve analysis were performed to explore the diagnostic value of Braden score for left main or three-vessel disease.

Results: Patients with more severe CAD had higher pressure ulcers risk. The percentage of high-pressure ulcers risk was highest in left main or three-vessel disease group, compared with control group and single- or two-vessel disease group. After adjusting for age, body mass index, diabetes, chronic kidney disease and other confounding factors, Braden score was an independent predictor of left main or three-vessel disease. Moreover, higher Braden score had a moderate area under the curve for excluding more severe CAD. In conclusion, among patients planning for coronary angiography, pressure ulcers risk assessment is conducive to predict the severity of obstructive CAD.

Keywords: coronary artery disease; predictive value; pressure ulcers.

Conflict of interest statement

None declared.

© 2021 The Authors. Nursing Open published by John Wiley & Sons Ltd.

Figures

FIGURE 1
FIGURE 1
Box plot of Braden scores across different severity of CAD
FIGURE 2
FIGURE 2
ROC curves by Braden scores for left main or three‐vessel disease probability. AUC, area under the curve

References

    1. Boyko, T. V. , Longaker, M. T. , & Yang, G. P. (2018). Review of the current management of pressure ulcers. Advances in Wound Care (New Rochelle), 7(2), 57–67. 10.1089/wound.2016.0697
    1. EPUAP, NPIAP, & PPPIA (2019). European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers/Injuries: Quick Reference Guide. Emily Haesler (Ed.). EPUAP/NPIAP/PPPIA.
    1. Finegold, J. A. , Asaria, P. , & Francis, D. P. (2013). Mortality from ischaemic heart disease by country, region, and age: Statistics from World Health Organisation and United Nations. International Journal of Cardiology, 168(2), 934–945. 10.1016/j.ijcard.2012.10.046
    1. Foy, A. J. , Dhruva, S. S. , Peterson, B. , Mandrola, J. M. , Morgan, D. J. , & Redberg, R. F. (2017). Coronary computed tomography angiography vs functional stress testing for patients with suspected coronary artery disease: A systematic review and meta‐analysis. JAMA Internal Medicine, 177(11), 1623–1631. 10.1001/jamainternmed.2017.4772
    1. Hoffmann, U. , Ferencik, M. , Udelson, J. E. , Picard, M. H. , Truong, Q. A. , Patel, M. R. , Huang, M. , Pencina, M. , Mark, D. B. , Heitner, J. F. , Fordyce, C. B. , Pellikka, P. A. , Tardif, J.‐C. , Budoff, M. , Nahhas, G. , Chow, B. , Kosinski, A. S. , Lee, K. L. , & Douglas, P. S. (2017). Prognostic value of noninvasive cardiovascular testing in patients with stable chest pain: Insights from the PROMISE trial (prospective multicenter imaging study for evaluation of chest pain). Circulation, 135(24), 2320–2332. 10.1161/circulationaha.116.024360
    1. Jaul, E. (2010). Assessment and management of pressure ulcers in the elderly: Current strategies. Drugs and Aging, 27(4), 311–325. 10.2165/11318340-000000000-00000
    1. Knuuti, J. , Wijns, W. , Saraste, A. , Capodanno, D. , Barbato, E. , Funck‐Brentano, C. , Prescott, E. , Storey, R. F. , Deaton, C. , Cuisset, T. , Agewall, S. , Dickstein, K. , Edvardsen, T. , Escaned, J. , Gersh, B. J. , Svitil, P. , Gilard, M. , Hasdai, D. , Hatala, R. , … Clapp, B. (2020). 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. European Heart Journal, 41(3), 407–477. 10.1093/eurheartj/ehz425
    1. Levine, J. M. (2020). Clinical aspects of aging skin: Considerations for the wound care practitioner. Advances in Skin & Wound Care, 33(1), 12–19. 10.1097/01.ASW.0000613532.25408.8b
    1. Lin, S. , Li, Z. , Fu, B. , Chen, S. , Li, X. I. , Wang, Y. , Wang, X. , Lv, B. , Xu, B. O. , Song, X. , Zhang, Y.‐J. , Cheng, X. , Huang, W. , Pu, J. , Zhang, Q. I. , Xia, Y. , Du, B. , Ji, X. , & Zheng, Z. (2020). Feasibility of using deep learning to detect coronary artery disease based on facial photo. European Heart Journal, 41, ehaa640. 10.1093/eurheartj/ehaa640
    1. Lowenstern, A. , Alexander, K. P. , Hill, C. L. , Alhanti, B. , Pellikka, P. A. , Nanna, M. G. , Mehta, R. H. , Cooper, L. S. , Bullock‐Palmer, R. P. , Hoffmann, U. , & Douglas, P. S. (2020). Age‐related differences in the noninvasive evaluation for possible coronary artery disease: insights from the prospective multicenter imaging study for evaluation of chest pain (PROMISE) trial. JAMA Cardiology, 5(2), 193–201. 10.1001/jamacardio.2019.4973
    1. Mahoney, F. I. , & Barthel, D. W. (1965). Functional evaluation: The Barthel index. Maryland State Medical Journal, 14, 61–65.
    1. Mervis, J. S. , & Phillips, T. J. (2019a). Pressure ulcers: Pathophysiology, epidemiology, risk factors, and presentation. Journal of the American Academy of Dermatology, 81(4), 881–890. 10.1016/j.jaad.2018.12.069
    1. Mervis, J. S. , & Phillips, T. J. (2019b). Pressure ulcers: Prevention and management. Journal of the American Academy of Dermatology, 81(4), 893–902. 10.1016/j.jaad.2018.12.068
    1. Moussa, I. D. , Jaff, M. R. , Mehran, R. , Gray, W. , Dangas, G. , Lazic, Z. , & Moses, J. W. (2009). Prevalence and prediction of previously unrecognized peripheral arterial disease in patients with coronary artery disease: The Peripheral Arterial Disease in Interventional Patients Study. Catheterization and Cardiovascular Interventions, 73(6), 719–724. 10.1002/ccd.21969
    1. Nicoll, R. , Wiklund, U. , Zhao, Y. , Diederichsen, A. , Mickley, H. , Ovrehus, K. , Zamorano, P. , Gueret, P. , Schmermund, A. , Maffei, E. , Cademartiri, F. , Budoff, M. , & Henein, M. (2016). The coronary calcium score is a more accurate predictor of significant coronary stenosis than conventional risk factors in symptomatic patients: Euro‐CCAD study. International Journal of Cardiology, 207, 13–19. 10.1016/j.ijcard.2016.01.056
    1. Patel, M. R. , Peterson, E. D. , Dai, D. , Brennan, J. M. , Redberg, R. F. , Anderson, H. V. , Brindis, R. G. , & Douglas, P. S. (2010). Low diagnostic yield of elective coronary angiography. New England Journal of Medicine, 362(10), 886–895. 10.1056/NEJMoa0907272
    1. Perneger, T. V. , Héliot, C. , Raë, A. C. , Borst, F. , & Gaspoz, J. M. (1998). Hospital‐acquired pressure ulcers: Risk factors and use of preventive devices. Archives of Internal Medicine, 158(17), 1940–1945. 10.1001/archinte.158.17.1940
    1. Poe, S. S. , Dawson, P. B. , Cvach, M. , Burnett, M. , Kumble, S. , Lewis, M. , Thompson, C. B. , & Hill, E. E. (2018). The Johns Hopkins fall risk assessment tool: A study of reliability and validity. Journal of Nursing Care Quality, 33(1), 10–19. 10.1097/NCQ.0000000000000301
    1. Qaseem, A. , Mir, T. P. , Starkey, M. , & Denberg, T. D. (2015). Risk assessment and prevention of pressure ulcers: A clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 162(5), 359–369. 10.7326/m14-1567
    1. Ragosta, M. , Dee, S. , Sarembock, I. J. , Lipson, L. C. , Gimple, L. W. , & Powers, E. R. (2006). Prevalence of unfavorable angiographic characteristics for percutaneous intervention in patients with unprotected left main coronary artery disease. Catheterization and Cardiovascular Interventions, 68(3), 357–362. 10.1002/ccd.20709
    1. Roshdy, H. S. , Soliman, M. H. , El‐Dosouky, I. I. , & Ghonemy, S. (2018). Skin aging parameters: A window to heart block. Clinical Cardiology, 41(1), 51–56. 10.1002/clc.22848
    1. Ruzsa, Z. , Pálinkás, A. , Forster, T. , Ungi, I. , & Varga, A. (2011). Angiographically borderline left main coronary artery lesions: Correlation of transthoracic Doppler echocardiography and intravascular ultrasound: A pilot study. Cardiovascular Ultrasound, 9, 19. 10.1186/1476-7120-9-19
    1. Squeri, A. , Gaibazzi, N. , Reverberi, C. , Caracciolo, M. M. , Ardissino, D. , & Gherli, T. (2012). Ejection fraction change and coronary artery disease severity: A vasodilator contrast stress‐echocardiography study. Journal of the American Society of Echocardiography, 25(4), 454–459. 10.1016/j.echo.2011.12.009
    1. Unger, T. , Borghi, C. , Charchar, F. , Khan, N. A. , Poulter, N. R. , Prabhakaran, D. , Ramirez, A. , Schlaich, M. , Stergiou, G. S. , Tomaszewski, M. , Wainford, R. D. , Williams, B. , & Schutte, A. E. (2020). 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertension, 75(6), 1334–1357. 10.1161/HYPERTENSIONAHA.120.15026

Source: PubMed

3
Abonnieren