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http://dx.doi.org/10.17703/IJACT.2019.7.2.13

Comorbidity Analysis on ICU Big Data  

Hyun, Sookyung (College of Nursing, Pusan National University)
Newton, Cheryl (Central Quality and Education, The Ohio State University Wexner Medical Center)
Publication Information
International Journal of Advanced Culture Technology / v.7, no.2, 2019 , pp. 13-18 More about this Journal
Abstract
Comorbidity isthe simultaneous presence of two chronic diseases or conditions in a patient. As part of a larger research study, the aims of this study were to explore comorbid conditions in intensive care unit (ICU) patients and to compare the comorbidity across different demographic groups, and to determine what comorbid health problems coexisted in the patients with hospital-acquired pressure injury (HAPI). The average number of comorbid conditions was 6.4 with range from 0-20 in the ICU patients. African American patients had significantly more comorbid health problems than other race/ethnicity groups. Asian and Hispanic female patients showed higher comorbidity than male patients across age. The patients with HAPIs had significantly more comorbid health problems than the patients without HAPIs -- the average numbers were almost two-fold. We found comorbid health problems that existed with HAPI in ICU patients. 'Other diseases of lung' and 'Disorders of fluid, electrolyte, and acid-base balance' were most frequently coexisting health problems in the ICU patients with HAPI. Exploratory plots are helpful to discover patterns or hypotheses relevant to clinical management in critical care. Inclusion of patients' comorbid health problems to ICU HAPI risk assessment may be helpful. Identification of patients at a high risk for the development of HAPI and the early preventative interventions can help reduce length of stay as well as costly complications.
Keywords
comorbidity; hospital-acquired pressure injury; intensive care units;
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1 National Pressure Ulcer Advisory Panel (NPUAP) announces a change in terminology from pressure ulcer to pressure injury and updates the stages of pressure injury [http://www.npuap.org/national-pressure-ulcer-advisory-panel-npuap-announces-a-change-in-terminology-from-pressure-ulcer-to-pressure-injury-and-updates-the-stages-of-pressure-injury/]
2 Goodman L, Khemani E, Cacao F, Yoon J, Burkoski V, Jarrett S, Collins B, Hall T. A comparison of hospital-acquired pressure injuries in intensive care and non-intensive care units: a multifaceted quality improvement initiative. BMJ Open Qual 2018, 7(4). doi: 10.1136/bmjoq-2018-000425.   DOI
3 Kriesberg Lange C, Little J, Mohr L, Kato K. Reducing Pressure Injuries in a Pediatric Cardiac Care Unit: A Quality Improvement Project. J Wound Ostomy Continence Nurs 2018, 45(6):497-502. doi: 10.1097/WON.0000000000000477.   DOI
4 Cox J. Pressure Injury Risk Factors in Adult Critical Care Patients: A Review of the Literature. Ostomy Wound Manage 2017, 63(11):30-43. PMID: 29166261   DOI
5 Linnen D, Kipnis P, Rondinelli J, Greene J, Liu V, Escobar G: Risk Adjustment for Hospital Characteristics Reduces Unexplained Hospital Variation in Pressure Injury Risk. Nurs Res 2018, 67(4):314-323.   DOI
6 Pacha H, Faria J, Oliveira K, Beccaria L. Pressure Ulcer in Intensive Care Units: a case-control study. Rev Bras Enferm 2018, 71(6):3027-3034. doi: 10.1590/0034-7167-2017-0950   DOI
7 Cox J, Roche S, Murphy V. Pressure Injury Risk Factors in Critical Care Patients: A Descriptive Analysis. Adv Skin Wound Care 2018, 31(7):328-334. doi: 10.1097/01.ASW.0000534699.50162.4e.   DOI
8 El-Marsi J, Zein-El-Dine, Zein B, Doumit R, Kurdahi Badr L. Predictors of Pressure Injuries in a Critical Care Unit in Lebanon: Prevalence, Characteristics, and Associated Factors. J Wound Ostomy Continence Nurs 2018, 45(2):131-136. doi: 10.1097/WON.0000000000000415.   DOI
9 Kaewprag P, Newton C, Vermillion B, Hyun S, Huang K, Machiraju R. Predictive models for pressure ulcers from intensive care unit electronic health records using Bayesian networks. BMC Med Inform Decis Mak 2017, 17(Suppl 2):65. doi: 10.1186/s12911-017-0471-z.   DOI
10 Greenfield S, Aronow H, Elashoff R, Watanabe D. Flaws in mortality data. The hazards of ignoring comorbid disease. JAMA 1988, 260(15):2253-2255. PMID: 3172404   DOI
11 Metheny NA, Frantz RA. Head-of-bed elevation in critically ill patients: a review. Crit Care Nurse 2013, 33(3):53-66. doi: 10.4037/ccn2013456.   DOI
12 Kneale C, Brown S: Uncharted forest: A technique for exploratory data analysis. Talanta 2018, 189:71-78. doi: 10.1016/j.talanta.2018.06.061.   DOI
13 Valderas J, Starfield B, Sibbald B, Salisbury C, Roland M. Defining comorbidity: implications for understanding health and health services. Ann Fam Med 2009, 7(4):357-363. doi: 10.1370/afm.983.   DOI
14 Patrick D, Deyo R. Generic and disease‐specific measures in assessing health status and quality of life. Med Care 1989, 27:217-232. PMID: 2646490   DOI
15 Henly S. Mother lodes and mining tools: big data for nursing science. Nurs Res 2014, 63(3):155. doi: 10.1097/NNR.0000000000000041.   DOI