Alternating pressure air mattresses in the intensive care unit as a cost-effective strategy for preventing stage III–IV pressure injuries: a retrospective cohort study

IF 2.4 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Clinics Pub Date : 2026-01-01 Epub Date: 2026-03-06 DOI:10.1016/j.clinsp.2026.100877

Serdar Efe , Coşkun Ateş , Mehmet Serdar Cengizhan , Pervin Hancı , Volkan İnal

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引用次数: 0

Abstract

Background

Pressure Injuries (PIs) are frequent, preventable complications in Intensive Care Units (ICUs), leading to morbidity, mortality, and increased healthcare costs. Alternating Pressure Air Mattresses (APAMs) have been proposed to reduce PI incidence, but real-world data remain scarce.

Objectives

To assess the effectiveness and cost-efficiency of APAMs in preventing PIs among critically ill patients.

Methods

This retrospective cohort study was conducted in a 10-bed tertiary ICU, comparing patients before and after APAM implementation. Multivariate logistic regression identified independent PI risk factors, and a cost-effectiveness model was developed using Number Needed to Treat (NNT) and treatment costs.

Results

APAM use reduced overall PI risk by 33% (RR = 0.67; 95% CI 0.45–0.98) and Stage III–IV ulcer risk by 84% (RR = 0.16; 95% CI 0.05–0.53). The NNT was 23, corresponding to net savings of USD 121,750 over five years for a 10-bed ICU, with cost recovery achieved within 4.3-months. Length of Stay (LOS) and prolonged mechanical ventilation independently increased PI risk by 19% and 13% per day, respectively. APAMs’ benefit was attenuated in patients with extended LOS and ventilation. Sepsis and respiratory failure increased PI risk in univariate analysis but lost significance after adjustment, indicating mediation by LOS and ventilation. APAMs eliminated the need for negative pressure wound therapy in this cohort.

Conclusions

APAMs significantly reduced severe PI incidence and treatment requirements in critically ill patients, demonstrating cost-effectiveness. Their protective effect was limited in patients with prolonged ICU stay or ventilation. Multicenter randomized trials are warranted, especially in diabetic and septic populations.

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在重症监护室使用交替压力气垫作为预防III-IV期压力损伤的成本效益策略：一项回顾性队列研究

背景：压力损伤（PIs）是重症监护病房（icu）常见的可预防的并发症，可导致发病率、死亡率和医疗费用增加。交替压力空气垫（APAMs）已被提出用于降低PI发生率，但实际数据仍然稀缺。目的：评价APAMs预防危重患者PIs的效果和成本效益。方法：回顾性队列研究在一个10张床位的三级ICU进行，比较APAM实施前后的患者。多变量逻辑回归确定了独立的PI危险因素，并使用治疗所需人数（NNT）和治疗费用建立了成本-效果模型。结果：APAM的使用降低了33%的PI风险（RR = 0.67; 95% CI 0.45-0.98）和84%的III-IV期溃疡风险（RR = 0.16; 95% CI 0.05-0.53）。NNT为23，相当于10个床位的ICU在5年内净节省121,750美元，在4.3个月内实现成本回收。住院时间（LOS）和延长机械通气分别使每日PI风险增加19%和13%。在延长LOS和通气的患者中，APAMs的益处减弱。脓毒症和呼吸衰竭在单因素分析中增加了PI风险，但调整后失去了显著性，表明LOS和通气起到了中介作用。APAMs消除了该队列负压伤口治疗的需要。结论：APAMs可显著降低危重患者严重PI发生率和治疗需求，具有成本效益。对于ICU住院时间较长或需要通气的患者，其保护作用有限。多中心随机试验是必要的，特别是在糖尿病和脓毒症人群中。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinics 医学-医学：内科

CiteScore

4.10

自引率

3.70%

发文量

129

审稿时长

52 days

期刊介绍： CLINICS is an electronic journal that publishes peer-reviewed articles in continuous flow, of interest to clinicians and researchers in the medical sciences. CLINICS complies with the policies of funding agencies which request or require deposition of the published articles that they fund into publicly available databases. CLINICS supports the position of the International Committee of Medical Journal Editors (ICMJE) on trial registration.