The Incidence of Oral Pressure Ulcers Related to Endotracheal Tubes: A Prospective Cohort Study

Abstract

Objective: To examine the incidence and implications of oral pressure ulcers (OPUs) associated with prolonged intubation and mechanical ventilation, particularly in patients in Intensive Care Units (ICUs). The purpose of the study was to determine the incidence of OPUs in ICU patients with endotracheal tube (ETT) placement.
Study Design: A prospective cohort study was conducted over six months, from 2 February 2024 to 25 July 2024.
Place and Duration of Study: Dr Ramelan Naval Hospital Surabaya Indonesia, during six months 2/02/2024-25/07/2024
Materials and Methods: A total of 372 ICU patients at Dr Ramelan Naval Hospital were included in this study. The participants were limited to ICU patients with ETT placement who presented with OPUs, without any age restriction. The exclusion criteria were patients without ETT and OPU, as well as patients who died before the observation period ended.
Results: The overall incidence of OPUs related to ETT placement was 16.13%, peaking 3–5 days after installation. Males exhibited a higher rate (55%) than females, with the age group 61–75 years and those with underlying pneumonia being the most affected. Mortality among patients was 55.38%, with 1.94% of these cases involving OPUs, while 44.62% survived, of which 33.73% developed OPUs. The higher incidence of OPUs resulted from prolonged pressure exerted by ETT placement, with a peak occurrence between 4–6 days post-ETT installation.
Conclusion: The incidence of OPUs related to ETT placement is relatively low at 16.13%. However, it is associated with a high mortality rate of 55.38%, underscoring the significant clinical impact of this complication. OPUs predominantly develop between 3–6 days post-ETT placement, highlighting the critical need for early identification and preventive measures during this period to improve patient outcomes.