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Utility and cost-effectiveness
of air suspension bed in the prevention of pressure ulcers
Francisco Pedro García Fernández,
Pedro Luis Pancorbo Hidalgo, María del Carmen Rodríguez
Torres
SUMMARY
Original paper:
Inman KJ, Sibbald WJ, Rutledge FS, Clark BJ. Clinical utility and
cost-effectiveness of an air suspension bed in the prevention pressure
ulcer. JAMA 1993; 269 (9): 1139-43.
Clinical practice question: This critical review tries
to respond to the question: Is clinically useful and do they have
a cost-effectiveness the air suspension beds in the prevention of
the pressure ulcers (pu) for critical patients, compared with the
standard mattresses? .
Summary of the research: Random clinical trial that compare
air suspension beds with standard mattresses. The authors find that
air surfaces provide to be clinically effective in the
prevention of the pu (odds ratio 0,18 [IC 95% 0,08-0,41]) and especially
in ulcers with severity score greater than 1 (OR= 0,16 [IC 95% 0,06-0,44)].
In risk patients the use of air surfaces is more cost-effective
than the standard mattresses of the hospital with a saving between
6.302,60 $ in Canada and 74.157,60 $ in USA.
Critical comment: Although the study was financed by the company
that manufacture the beds, the design and the rigor of the research
doesn't invalidate the results. Another methodological problem is
that APACHE score is used for patients classification instead of
a PU risk assessment scale. The effectiveness of pressure-relief
surfaces in the prevention of PU has been largely validated by different
clinical trial from the years 80 and confirmed by systematic reviews.
Cost-effectiveness of these surfaces has also been demonstrated
by works carried out in Spain. Also, we can state that there is
appropriate evidence, (A), to recommend the use of air-dynamic surfaces
for PU prevention because it is an intervention clinically useful
and cost-effective.
KEY WORDS
Critical review, evidence, pressure ulcers, prevention, air suspension
bed, clinical trial.
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