AUTHOR=Sousa Vitória Alice Alencar , Ferreira Daniele Nunes da Silva , Mendonça Giovana Vitória Guimarães , Marinho Rebecca Lobato , Andrade Natasha Cristina Oliveira , Soares Tamires de Nazaré , Silva Marcos Jessé Abrahão , Lobato Diana da Costa , dos Santos Suziane do Socorro , Rodrigues Yan Corrêa , Sardinha Daniele Melo , Lima Luana Nepomuceno Gondim Costa 

TITLE=Factors associated with medical device-related pressure injury in an intensive care unit in the Amazon region during the COVID-19 pandemic: retrospective cohort

JOURNAL=Frontiers in Medicine

VOLUME=Volume 12 - 2025

YEAR=2025

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2025.1605584

DOI=10.3389/fmed.2025.1605584

ISSN=2296-858X

ABSTRACT=Medical device–related pressure injuries (MDRPIs) pose a serious public health challenge, particularly in intensive care settings during the COVID-19 pandemic. This retrospective cohort study aimed to characterize the profile and identify risk and protective factors for MDRPIs among adult ICU patients in a metropolitan region of the Amazon between January 2021 and December 2022. We reviewed 603 medical records—31 patients (5.1%) developed MDRPIs and 572 did not—and applied chi-square tests, normality assessments, Mann–Whitney U-tests, binary logistic regression, and Kaplan–Meier survival analysis. Ethical approval was obtained from the Fundação Hospital de Clínicas Gaspar Viana Ethics Committee (approval no. 5,991,542). Independent risk factors for MDRPIs included chronic obstructive pulmonary disease (OR 19.33; 95% CI 2.92–127.73; p = 0.002), orotracheal tube use (OR 19.00; p = 0.002), nasal catheter use (OR 3.33; 95% CI 1.32–8.40; p = 0.011), and longer hospital stay (OR 1.09 per day; 95% CI 1.05–1.12; p < 0.001). Protective factors were systemic arterial hypertension (OR 0.22; 95% CI 0.08–0.58; p = 0.009), higher Braden scale scores (OR 0.22 per point; 95% CI 0.08–0.58; p = 0.002), and invasive arterial blood pressure monitoring (OR 0.14; 95% CI 0.03–0.79; p = 0.025). Survival analysis demonstrated that patients with MDRPIs had significantly longer hospital stays and higher mortality rates (Breslow p = 0.007; log-rank p = 0.041; Tarone–Ware p = 0.011). This first study of MDRPIs in the Amazon region highlights key modifiable factors and underscores the need for enhanced nursing protocols and working conditions to prevent device-related pressure injuries in critical care. These findings can guide continuing education initiatives and policy development in critical care nursing.