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Journals / Bozok Tıp Dergisi / 2026 / Cilt: 16 Sayı: 2

ASSOCIATION OF INFLAMMATORY BIOMARKERS WITH EARLIER PRESSURE ULCER DEVELOPMENT IN INTENSIVE CARE UNIT PATIENTS

Yoğun Bakım Ünitesi Hastalarında Enflamatuar Biyobelirteçlerin Daha Erken Bası Yarası Gelişimi ile İlişkisi

Emrah Işıktekin(BALIKESİR ÜNİVERSİTESİ TIP FAKÜLTESİ, PLASTİK REKONSTÜRKTİF VE ESTETİK CERRAHİ ANA BİLİM DALI)0000-0001-6068-9899
Melike Demir İsiktekin(Balıkesir Atatürk Şehir Hastanesi)0000-0002-9909-6924
Pages
322–328
Publication Date
2026-06-15
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Conclusion: Inflammation-based markers, particularly CAR, are associated with earlier pressure ulcer development and may improve risk stratification beyond conventional assessment tools.

📌 3 Key Takeaways

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Objective & Hypothesis:Objective: Pressure ulcers are a common complication in intensive care unit (ICU) patients.
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Key Findings & Data:Due to potential collinearity, separate multivariable models were constructed for CAR and modified Glasgow Prognostic Score (mGPS).
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Conclusion & Impact:Conclusion: Inflammation-based markers, particularly CAR, are associated with earlier pressure ulcer development and may improve risk stratification beyond conventional assessment tools.
🔬Design:Modeling & Simulation
📍Scope:Comprehensive Sample
⚙️Variables:Bası Ülseri · C-Reaktif Protein · Albümin

Abstract

Objective: Pressure ulcers are a common complication in intensive care unit (ICU) patients. While traditional risk assessment tools primarily focus on mechanical and functional factors, the role of systemic inflammation in determining the timing of ulcer development remains unclear. This study aimed to evaluate the association between inflammation-based markers, particularly the C-reactive protein-albumin ratio (CAR), and time to pressure ulcer development. Material and Methods: Seventy-four ICU patients who developed pressure ulcers were retrospectively analyzed. The primary outcome was defined as the time (in days) from ICU admission to pressure ulcer occurrence. Associations between variables were assessed using Spearman’s correlation analysis. Cox proportional hazards regression analysis was performed to identify independent predictors of earlier pressure ulcer development. Due to potential collinearity, separate multivariable models were constructed for CAR and modified Glasgow Prognostic Score (mGPS). Kaplan-Meier analysis was used to compare time to ulcer development between groups, and differences were assessed using the log-rank test. Results: CAR was strongly and negatively correlated with time to pressure ulcer development (rho=−0.599, p<0.001). Age and body mass index showed weaker negative correlations, while the Braden score was not significantly associated with time to ulcer development. In multivariable Cox regression analysis, CAR was independently associated with earlier pressure ulcer development (HR=1.41, 95% CI 1.24-1.60, p<0.001). In a separate model, mGPS was also independently associated with earlier pressure ulcer development (HR=5.20, 95% CI 2.86-9.43, p<0.001). Kaplan-Meier analysis demonstrated significantly shorter time to ulcer development in patients with higher CAR levels (log-rank p<0.001). Conclusion: Inflammation-based markers, particularly CAR, are associated with earlier pressure ulcer development and may improve risk stratification beyond conventional assessment tools.

Özet

Amaç: Bası ülserleri, yoğun bakım ünitesi (YBÜ) hastalarında sık görülen komplikasyonlardır. Geleneksel risk değerlendirme araçları çoğunlukla mekanik ve fonksiyonel faktörlere odaklanırken, sistemik inflamasyonun bası ülseri gelişim zamanlaması üzerindeki etkisi tam olarak aydınlatılamamıştır. Bu çalışmada, C-reaktif protein-albümin oranı (CAR) temel alınarak inflamasyon belirteçleri ile bası ülseri gelişimine kadar geçen süre arasındaki ilişkinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler: Bası ülseri gelişen 74 yoğun bakım hastası retrospektif olarak analiz edildi. Birincil sonlanım noktası, yoğun bakım yatışı ile bası ülseri gelişimi arasındaki süre (gün) olarak tanımlandı. Değişkenler arasındaki ilişkiler Spearman korelasyon analizi ile değerlendirildi. Bası ülseri gelişim süresi ile ilişkili bağımsız faktörleri belirlemek amacıyla Cox orantısal risk regresyon analizi kullanıldı. İnflamasyon belirteçleri arasındaki olası kolinerite nedeniyle, CAR ve modifiye Glasgow Prognostik Skoru (mGPS) için ayrı çok değişkenli modeller oluşturuldu. Gruplar arasında bası ülseri gelişim süresi Kaplan-Meier analizi ile karşılaştırıldı ve farklar log-rank testi ile değerlendirildi. Bulgular: CAR ile bası ülseri gelişim süresi arasında güçlü ve negatif yönde anlamlı bir korelasyon saptandı (rho=-0,599, p<0,001). Yaş ve vücut kitle indeksi daha zayıf negatif korelasyon gösterirken, Braden skoru ile gelişim süresi arasında anlamlı ilişki bulunmadı. Çok değişkenli Cox regresyon analizinde CAR, daha erken bası ülseri gelişimi ile bağımsız olarak ilişkili bulundu (HR=1,41, %95 GA 1,24-1,60, p<0,001). Ayrı bir modelde mGPS de daha erken gelişim ile bağımsız olarak ilişkili saptandı (HR=5,20, %95 GA 2,86-9,43, p<0,001). Kaplan-Meier analizinde, yüksek CAR düzeylerine sahip hastalarda bası ülseri gelişim süresinin anlamlı olarak daha kısa olduğu gösterildi (log-rank p<0,001). Sonuç: İnflamasyon temelli belirteçler, özellikle CAR, bası ülserinin daha erken gelişimi ile ilişkilidir ve gele­neksel risk değerlendirme araçlarının ötesinde risk sınıflandırmasını geliştirebilir.

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Cite This Article

Işıktekin, E., İsiktekin, M. D. (2026). ASSOCIATION OF INFLAMMATORY BIOMARKERS WITH EARLIER PRESSURE ULCER DEVELOPMENT IN INTENSIVE CARE UNIT PATIENTS. Bozok Tıp Dergisi, Cilt: 16 Sayı: 2, 322–328. https://doi.org/10.16919/bozoktip.1921159

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