The Pressure Ulcers Monitoring in Patiens with Neurological Diseases – Analyse of the National Register of Hospitalized Patients
A. Pokorná 1; K. Benešová 2,3; J. Mužík 2,3; P. Búřilová 1; J. Jarkovský 2,3; L. Dušek 2,3
Authors‘ workplace: Katedra ošetřovatelství, LF MU, Brno 1; Institut biostatistiky a analýz, LF MU, Brno 2; Ústav zdravotnických informací a statistiky ČR, Praha 3
Published in: Cesk Slov Neurol N 2016; 79/112(Supplementum1): 8-14
Category: Original Paper
The aim of this study was to analyse hospital stays related to pressure ulcers (according to ICD 10) in acute and long-term care facilities in the Czech Republic (2007–2014) in neurologically ill patients with limited mobility.
Material and methods:
Observational cross-sectional study using routinely collected data from the National Register of Hospitalized Patients.
Of total 17,762,854 hospital records 8,150 (0.05%) had the selected neurological diagnosis and pressure ulcers (L89). Detailed analyses were performed in 4,924 records (0.03%): patients with the selected neurological diagnosis and with a pressure ulcer as a primary diagnosis (n = 75); neurological diagnosis as the primary diagnosis and pressure sores as a secondary diagnosis (n = 3,248); a pressure sore as the only primary diagnosis in patients with a selected neurological diagnosis (n = 1,601). Neurological diagnoses included: brain injury and bleeding (n = 2,766); neurodegenerative and oncological diseases (n = 1,707); spinal cord traumatic injury (n = 451).
Duration of hospitalization in patients with pressure ulcers in an acute care setting differs according to the main neurological diagnosis and whether the pressure ulcer was listed as the primary or secondary diagnosis (p < 0.001). Duration of hospital stay differs in an long-term care setting according to the grade of pressure ulcer (p = 0.040). In acute and long-term settings, the age of patients with pressure ulcers is statistically significantly different according to the neurological diagnosis and grade of pressure sore (p < 0.001).
epidemiology – pressure ulcer – hospitalization – monitoring – national registries – neurological diseases
The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.
The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.
1. European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel. Treatment of pressure ulcers: Quick Reference Guide. Washington DC: National Pressure Ulcer Advisory Panel 2009.
2. Haesler E. National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline. Cambridge Media: Osborne Park, Western Australia 2014.
3. Langemo DK, Melland H, Hanson D, et al. The lived experience of having a pressure ulcer: a qualitative analysis. Adv Skin Wound Care 2000;13(5):225– 35.
4. Stroupe K, Manheim L. Cost of treating pressure ulcers for veterans with spinal cord injury. Top Spinal Cord Inj Rehabil 2011;16(4):62– 73. doi: http:/ / dx.doi.org/ 10.1310/ sci1604-62.
5. Chan BC, Nanwa N, Mittmann N, et al. The average cost of pressure ulcer management in a community dwelling spinal cord injury population. Int Wound J 2013;10(4):431– 40. doi: 10.1111/ j.1742-481X.2012.01002.x.
6. Reddy M. Pressure ulcers. BMJ Clin Evid 2015;2011: 1901.
7. Zakrasek EC, Creasey G, Crew JD. Pressure ulcers in people with spinal cord injury in developing nations. Spinal Cord 2015;53(1):7– 13. doi: 10.1038/ sc.2014.179.
8. Gunningberg L, Hommel A, Bååth C, et al. The first national PU prevalence survey in county council and municipality settings in Sweden. J Eval Clin Pract 2013;19(5):862– 7. doi: 10.1111/ j.1365-2753.2012.01865.x.
9. Kottner J, Dassen T, Lahmann N. Prevalence of deep tissue injures in hospitals and nursing homes: two cross--sectional studies. Int J Nurs Stud 2010;47(6):665– 70. doi: 10.1016/ j.ijnurstu.2009.11.003.
10. Moore Z, Cowman Z. Pressure ulcer prevalence and prevention practices in care of the older person in the Republic of Ireland. J Clin Nurs 2011;21(3– 4):362– 71. doi: 10.1111/ j.1365-2702.2011.03749.x.
11. Vanderwee K, Defloor T, Beeckman D, et al. Assessing the adequacy of PU prevention in hospitals: a nationwide prevalence survey. BMJ Qual Saf 2011;20(3):260– 7. doi: 10.1136/ bmjqs.2010.043125.
12. VanDenKerkhof EG, Friedberg E, Harrison B. Prevalence and risk of pressure ulcers in acute care following implementation of practice guidelines: annual pressure ulcer prevalence census 1994– 2008. J Health Qual 2011;33(5):58– 67. doi: 10.1111/ j.1945-1474.2011.00127.x.
13. Jenkins ML, O‘Neal E. Pressure ulcer prevalence and incidence in acute care. Adv Skin Wound Care 2010;23(12):556– 9. doi: 10.1097/ 01.ASW.0000391184.43 845.c1.
14. Coomer NM, McCall NT. Examination of the accuracy of coding hospital-acquired pressure ulcer stages. Medicare Medicaid Res Rev 2013;3(4). doi: 10.5600/ mmrr.003.04.b03.
15. Russo CA, Steiner C, Spector W. Hospitalizations Related to Pressure Ulcers. [online]. Available from URL: http:/ / www.hcup-us.ahrq.gov/ reports/ stat-briefs/ sb64.pdf.
16. Meddings JA, Reichert H, Hofer T, et al. Hospital report cards for hospital-acquired pressure ulcers: how good are the grades? Ann Intern Med 2013;159(8):505– 13. doi: 10.7326/ 0003-4819-159-8-201310150-00003.
17. Gunningberg L, Donaldson N, Aydin C, et al. Exploring variation in pressure ulcer prevalence in Sweden and the USA: benchmarking in action. J Eval Clin Pract 2012;18(4):904– 10. doi: 10.1111/ j.1365-2753.2011.01702.x.
18. Jiang Q, Li X, Qu X, et al. The incidence, risk factors and characteristics of pressure ulcers in hospitalized patients in China. Int J Clin Exp Pathol 2014;7(5):2587– 94.
19. Demarré L, Verhaeghe S, Annemans L, et al. The cost of pressure ulcer prevention and treatment in hospitals and nursing homes in Flanders: A cost-of-illness study. Int J Nurs Stud 2015;52(7):1166– 79. doi: 10.1016/ j.ijnurstu.2015.03.005.
20. Demarré L, Van Lancker A, Van Hecke A, et al. The cost of prevention and treatment of pressure ulcers: a systematic review. Int J Nurs Stud 2015;52(11):1754– 74. doi: 10.1016/ j.ijnurstu.2015.06.006.
21. Eslami V, Saadat S, Habibi Arejan R, et al. Factors associated with the development of pressure ulcers after spinal cord injury. Spinal Cord 2012;50(12):899– 903. doi: 10.1038/ sc.2012.75.
22. Ljung AC, Stenius MC, Bjelak S, et al. Surgery for pressure ulcers in spinal cord-injured patients following a structured treatment programme: a 10-year follow-up. Int Wound J 2016. doi: 10.1111/ iwj.12609.
23. Clark FA, Jackson JM, Scott MD, et al. Data-based models of how pressure ulcers develop in daily-living contexts of adults with spinal cord injury. Arch Phys Med Rehabil 2006;87(11):1516– 25.
24. Stroupe K, Manheim L, Evans C, et al. Cost of treating pressure ulcers for veterans with spinal cord injury. Top Spinal Cord Inj Rehabil 2011;16(4):62– 73. doi: http:/ / dx.doi.org/ 10.1310/ sci1604-62.
25. Collier M. Pressure Ulcer Incidence: the Development and Benefits of 10 Year’s-experience with an Electronic Monitoring Tool (PUNT) in a UK Hospital Trust. EWMA J 2015;15(2):15– 20.
26. Öien RF. RUT (Register of Ulcer Treatment) – a winning concept for both patients and the health care sector. EWMA J 2009; 9:41– 4.
LabelsPaediatric neurology Neurosurgery Neurology
Article was published in
Czech and Slovak Neurology and Neurosurgery
2016 Issue Supplementum1
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