Pressure sores among hospitalized patients.

A cross-sectional survey was done to determine the prevalence of pressure sores in hospitalized patients and the factors associated with having a pressure sore in the hospital. Among 634 adult patients, 30 (4.7%; 3.1% to 6.3%, 95% confidence interval) had a pressure sore and 78 (12.3%; 9.8% to 14.8%) were at risk for a pressure sore because they had been confined to a bed or chair for at least 1 week. Comparing these two groups of patients, we found that fecal incontinence, diarrhea, fractures, urinary catheter use, decreased weight, dementia, and hypoalbuminemia were associated with having pressure sores (p less than or equal to 0.05). Using logistic regression analysis, hypoalbuminemia, fecal incontinence, and fractures remained significantly and independently associated with having a pressure sore (odds ratios = 3.0, 3.1, and 5.2, respectively; p less than or equal to 0.05). Our findings suggest that 17% (14% to 20%) of hospitalized patients have pressure sores or are at risk for them, and that hypoalbuminemia, fecal incontinence, and fractures may identify bedridden patients at greatest risk.

[1]  C. F. Anderson,et al.  The sensitivity and specificity of nutrition-related variables in relationship to the duration of hospital stay and the rate of complications. , 1984, Mayo Clinic proceedings.

[2]  C. Bryan,et al.  Bacteremia associated with decubitus ulcers. , 1983, Archives of internal medicine.

[3]  E. J. Young,et al.  Osteomyelitis beneath pressure sores. , 1983, Archives of internal medicine.

[4]  E. Bach,et al.  Decubitus prophylaxis: a prospective trial on the efficiency of alternating-pressure air-mattresses and water-mattresses. , 1983, Acta dermato-venereologica.

[5]  S. A. Kvorning,et al.  Medical Aspects of the Decubitus Ulcer , 1982, International journal of dermatology.

[6]  E. Rubinstein,et al.  Estimating the effects of nosocomial infections on the length of hospitalization. , 1982, The Journal of infectious diseases.

[7]  C. F. Anderson,et al.  The utility of serum albumin values in the nutritional assessment of hospitalized patients. , 1982, Mayo Clinic proceedings.

[8]  A. Detsky,et al.  Nutritional assessment: a comparison of clinical judgement and objective measurements. , 1982, New England Journal of Medicine.

[9]  A. Ek,et al.  A descriptive study of pressure sores: the prevalence of pressure sores and the characteristics of patients. , 1982, Journal of advanced nursing.

[10]  Pressure ulcers in the elderly: prevention and treatment utilizing the team approach. , 1981 .

[11]  S. Brodine,et al.  Infections among patients in nursing homes: policies, prevalence, problems. , 1981, The New England journal of medicine.

[12]  J. Reuler,et al.  The pressure sore: pathophysiology and principles of management. , 1981, Annals of internal medicine.

[13]  C. F. Anderson,et al.  Nutritional assessment of orthopedic patients. , 1981, Mayo Clinic proceedings.

[14]  A. Ameis,et al.  Management of pressure sores. Comparative study in medical and surgical patients. , 1980, Postgraduate medicine.

[15]  B. Rosner,et al.  Adverse effects of nosocomial infection. , 1979, The Journal of infectious diseases.

[16]  L. Goldstone,et al.  A survey of pressure sores in the over sixties on two orthopaedic wards. , 1979, International journal of nursing studies.

[17]  I McColl,et al.  Firm, patient, and process variables associated with length of stay in four diseases , 1978, British medical journal.

[18]  Manley Mt Incidence, contributory factors and costs of pressure sores. , 1978 .

[19]  J. Barbenel,et al.  INCIDENCE OF PRESSURE-SORES IN THE GREATER GLASGOW HEALTH BOARD AREA , 1977, The Lancet.

[20]  A. Chow,et al.  Sepsis associated with decubitus ulcers. , 1976, The American journal of medicine.

[21]  P. Lamy,et al.  The Problem of Pressure Sores in a Nursing Home Population: Statistical Data , 1976, Journal of the American Geriatrics Society.

[22]  P. Lowthian Underpads in the Prevention of Decubiti , 1976 .

[23]  J. D. Shea Pressure sores: classification and management. , 1975, Clinical orthopaedics and related research.

[24]  L. Gerson The incidence of pressure sores in active treatment hospitals. , 1975, International journal of nursing studies.

[25]  D. Gosnell,et al.  An Assessment Tool to Identify Pressure Sores , 1973, Nursing research.

[26]  A. Williams A STUDY OF FACTORS CONTRIBUTING TO SKIN BREAKDOWN , 1972, Nursing research.

[27]  N. Petersen,et al.  The epidemiology of pressure sores. , 1971, Scandinavian journal of plastic and reconstructive surgery.

[28]  Houle Rj,et al.  Evaluation of seat devices designed to prevent ischemic ulcers in paraplegic patients. , 1969 .

[29]  A N Exton-Smith,et al.  Preventing pressure sores in hospital: controlled trial of a large-celled ripple mattress. , 1967, British medical journal.

[30]  T. Rudd THE PATHOGENESIS OF DECUBITUS ULCERS , 1962, Journal of the American Geriatrics Society.

[31]  M. Kosiak,et al.  Etiology of decubitus ulcers. , 1961, Archives of physical medicine and rehabilitation.

[32]  M. Kosiak,et al.  Etiology and pathology of ischemic ulcers. , 1959, Archives of physical medicine and rehabilitation.