The Risk Factors of Postoperative Pressure Ulcer After Liver Resection With Long Surgical Duration

A Retrospective Study

Hong-Lin Chen, MD; Ai-Gui Jiang, MD; Bin Zhu, MD; Ji-Yu Cai, MM; Yi-Ping Song, MM


Wounds. 2019;31(9):242-245. 

In This Article

Materials and Methods

Patient Population

A retrospective analysis was performed by reviewing deidentified medical record data from the Second Affiliated Hospital of Nantong University (Nantong, Jiangsu, China). The study was approved by the medical ethics committee of the Second Affiliated Hospital of Nantong University. Inclusion criteria consisted of patients who underwent a liver resection, with a surgical duration greater than 2 hours, between January 2015 and December 2016 and received a postoperative PU assessment. Patients were excluded if a PU developed before liver resection surgery, patients died during operation or after surgery during hospitalization, or if important data, especially PU information, were missing.

Data Collection

A retrospective review of electronic medical records was used to obtain data based on the Hospital Information System (HIS) of the authors' hospital, a tertiary referral hospital in eastern China. Predesigned Excel (Microsoft Corporation, Redwood, WA) sheets were used to collect patient information, including demographic characteristics (hospital number, age, and body mass index [BMI]), health status at admission (admission hemoglobin [Hb], admission albumin [Alb], and diabetes mellitus [DM] status [yes or no]), surgery information (length of surgery [minutes] and intraoperative blood loss [mL]), and postoperative PU information (PU occurrence time [days after surgery], location [sacrum and coccyx, heel, or ischial tuberosity], and stage). Pressure ulcers were diagnosed according to the National Pressure Ulcer Advisory Panel.[5]

First, the HIS was electronically searched for the aforementioned collected patient information. Then, if the information could not be found by computer search, the authors manually searched the medical records according to hospital number. Once data were collected, all patients were categorized into 2 separate groups: those who developed postsurgical PU and those who did not develop PU. All data were collected by a senior research nurse.

Statistical Analysis

Characteristics for patients who developed PU and those without PU were compared by univariate analysis. Continuous variables were tested by t test, and categorical variables were tested by chi-square test or Fischer exact test. These variables were then included in multivariate logistic regression to find out the independent risk factors for postoperative PU of this patient population. Statistical analyses were performed using Stata software (version 11.0; StataCorp LLC, College Station, TX).