References

Brem H, Maggi J, Nierman D High cost of stage IV pressure ulcers. Am J Surg. 2010; 200:(4)473-477 https://doi.org/10.1016/j.amjsurg.2009.12.021

Kim CH, Lim CY, Lee JH Human embrionic stem cells-derived mesenchymal stem cells reduce the symptom of psoriasis in imiquimod induced skin model. Tissue Eng Regen Med. 2019; 16:(1)93-102 https://doi.org/10.1007/s13770-018-0165-3

Chou R, Dana T, Bougatsos C Pressure ulcer risk assessment and prevention: a systematic comparative effectiveness review. Ann Intern Med. 2013; 159:(1)28-38 https://doi.org/10.7326/0003-4819-159-1-201307020-00006

Garcia AD, Thomas DR. Assessment and management of chronic pressure ulcers in the elderly. Med Clin North Am. 2006; 90:(5)925-944 https://doi.org/10.1016/j.mcna.2006.05.018

Chabanon M, Duval H, Grenier J Histological method to study the effect of shear stress on cell proliferation and tissue morphology in a bioreactor. Tissue Eng Regen Med. 2019; 16:(3)225-235 https://doi.org/10.1007/s13770-019-00181-3

Smit I, Harrison L, Letzkus L, Quatrara B. What factors are associated with the development of pressure ulcers in a medical intensive care unit?. Dimens Crit Care Nurs. 2016; 35:(1)37-41 https://doi.org/10.1097/DCC.0000000000000153

Chou CL, Lee WR, Yeh CC Adverse outcomes after major surgery in patients with pressure ulcer: a nationwide population-based retrospective cohort study. PLoS One. 2015; 10:(5) https://doi.org/10.1371/journal.pone.0127731

Webster J, Lister C, Corry J Incidence and risk factors for surgically acquired pressure ulcers: a prospective cohort study investigators. J Wound Ostomy Continence Nurs. 2015; 42:(2)138-144 https://doi.org/10.1097/WON.0000000000000092

Lyder CH, Wang Y, Metersky M Hospital-acquired pressure ulcers: results from the national Medicare Patient Safety Monitoring System study. J Am Geriatr Soc. 2012; 60:(9)1603-1608 https://doi.org/10.1111/j.1532-5415.2012.04106.x

Park TH, Choi JC. Validation of stroke and thrombolytic therapy in Korean National Health Insurance Claim data. J Clin Neurol. 2016; 12:(1)42-48 https://doi.org/10.3988/jcn.2016.12.1.42

Ko YJ, Kim S, Park K Impact of the health insurance coverage policy on oral anticoagulant prescription among patients with atrial fibrillation in Korea from 2014 to 2016. J Korean Med Sci. 2018; 33:(23) https://doi.org/10.3346/jkms.2018.33.e163

Sung YK, Cho SK, Choi CB, Bae SC. Prevalence and incidence of rheumatoid arthritis in South Korea. Rheumatol Int. 2013; 33:(6)1525-1532 https://doi.org/10.1007/s00296-012-2590-2

Kim JA, Yoon S, Kim LY, Kim DS. Towards actualizing the value potential of Korea Health Insurance Review and Assessment (HIRA) data as a resource for health research: strengths, limitations, applications, and strategies for optimal use of HIRA data. J Korean Med Sci. 2017; 32:(5)718-728 https://doi.org/10.3346/jkms.2017.32.5.718

Jaul E, Rosenzweig JP. A retrospective study of the impact of pressure ulcers on survival in elderly persons with chronic diseases. Ostomy Wound Manage. 2017; 63:(5)26-32

Ousey K. Pressure ulcers: understanding the challenges of promoting quality. Br J Nurs. 2010; 19:(12)755-760 https://doi.org/10.12968/bjon.2010.19.12.48653

Posnett J, Gottrup F, Lundgren H, Saal G. The resource impact of wounds on health-care providers in Europe. J Wound Care. 2009; 18:(4)154-161 https://doi.org/10.12968/jowc.2009.18.4.41607

Clark M. Pressure ulcers: have we overlooked valuable data?. Int Wound J. 2004; 1:(2) https://doi.org/10.1111/j.1742-4801.2004.00040b.x

Vowden K, Vowden P, Posnett J. The resource costs of wound care in Bradford and Airedale primary care trust in the UK. J Wound Care. 2009; 18:(3)93-102 https://doi.org/10.12968/jowc.2009.18.3.39814

Bansal C, Scott R, Stewart D, Cockerell CJ. Decubitus ulcers: a review of the literature. Int J Dermatol. 2005; 44:(10)805-810 https://doi.org/10.1111/j.1365-4632.2005.02636.x

Won HR, Seo C, Lee HY An important role of macrophages for wound margin regeneration in an murine flap model. Tissue Eng Regen Med. 2019; 16:(6)667-674 https://doi.org/10.1007/s13770-019-00214-x

Khor HM, Tan J, Saedon NI Determinants of mortality among older adults with pressure ulcers. Arch Gerontol Geriatr. 2014; 59:(3)536-541 https://doi.org/10.1016/j.archger.2014.07.011

Leblebici B, Turhan N, Adam M, Akman MN. Clinical and epidemiologic evaluation of pressure ulcers in patients at a university hospital in Turkey. J Wound Ostomy Continence Nurs. 2007; 34:(4)407-411 https://doi.org/10.1097/01.WON.0000281657.63449.1c

Anthony D, Alosoumi D, Safari R. Prevalence of pressure ulcers in long-term care: a global review. J Wound Care. 2019; 28:(11)702-709 https://doi.org/10.12968/jowc.2019.28.11.702

Moore Z, Avsar P, Conaty L The prevalence of pressure ulcers in Europe, what does the European data tell us: a systematic review. J Wound Care. 2019; 28:(11)710-719 https://doi.org/10.12968/jowc.2019.28.11.710

Fogerty MD, Abumrad NN, Nanney L Risk factors for pressure ulcers in acute care hospitals. Wound Repair Regen. 2008; 16:(1)11-18 https://doi.org/10.1111/j.1524-475X.2007.00327.x

House S, Giles T, Whitcomb J. Benchmarking to the international pressure ulcer prevalence survey. J Wound Ostomy Continence Nurs. 2011; 38:(3)254-259 https://doi.org/10.1097/WON.0b013e318215fa48

An executive summary of the National Pressure Ulcer Advisory Panel monograph. Adv Skin Wound Care. 2001; 14:(4)208-215

Kröger K, Niebel W, Maier I Prevalence of pressure ulcers in hospitalized patients in Germany in 2005: data from the Federal Statistical Office. Gerontology. 2009; 55:(3)281-287 https://doi.org/10.1159/000174825

Flattau A, Blank AE. Risk factors for 90-day and 180-day mortality in hospitalised patients with pressure ulcers. Int Wound J. 2014; 11:(1)14-20 https://doi.org/10.1111/j.1742-481X.2012.01032.x

Gusenoff JA, Redett RJ, Nahabedian MY. Outcomes for surgical coverage of pressure sores in nonambulatory, nonparaplegic, elderly patients. Ann Plast Surg. 2002; 48:(6)633-640 https://doi.org/10.1097/00000637-200206000-00012

Cui HS, Cho YS, Joo SY Wound healing potential of low temperature plasma in human primary epidermal keratinocytes. Tissue Eng Regen Med. 2019; 16:(6)585-593 https://doi.org/10.1007/s13770-019-00215-w

Jósvay J, Klauber A, Both B The operative treatment of pressure sores in the pelvic region: a 10-year period overview. J Spinal Cord Med. 2015; 38:(4)432-438 https://doi.org/10.1179/2045772314Y.0000000266

Pressure ulcers

Wound healing

Incidence and prevalence of pressure ulcers in hospitals: 10-year cohort study

01 December 2021

Research

Abstract

Objective:

Pressure ulcers (PUs) are a serious problem in patients with multiple comorbidities and are associated with a longer duration of hospital stay and higher medical costs. The aetiology and rate of PU occurrence in South Korea remains unclear. Therefore, we aimed to determine the incidence, prevalence, mortality and common comorbidities of hospitalised patients with PUs in the South Korean healthcare system.

Method:

A 10-year cohort study using the healthcare insurance reimbursement claims from the South Korean National Health Insurance System database. Patients diagnosed with a PU on admission to hospital [ICD-10: L89 + procedure code] between January 2002 and December 2016 were included and their comorbidities evaluated. Patients <20 years of age and recurrent PU cases were excluded.

Results:

Incidence, prevalence, survival rate and risk factors related to survival rate of patients with PUs were determined. The study population in 2006 was 36,195,121 (all patients admitted to hospital that year), which changed yearly because of the inclusion of additional patients who met the study inclusion criteria, and removal of patients who had died during the year. Standardised PU incidence rate decreased from 17.1 in 2006 to 14.9 in 2015 per 10,000 people. Standardised PU prevalence also showed a slightly decreasing trend from 20.2 in 2006 to 18.9 in 2015 per 10,000 people.

Conclusion:

This findings of this 10-year study showed that incidence and prevalence of PUs markedly increased with age after the seventh decade. Incidence of PUs increased in patients with pneumonia, cerebral infarction, sepsis, femoral neck fracture and malignant neoplasm of the bronchus. Patients with femoral neck fracture and cerebral infarction showed a higher rate of survival than those with other high-risk comorbidities.

Pressure ulcers (PUs) are common in patients with serious illnesses and/or physical impairment.^1,2 In the US, 1.3–3 million individuals were estimated to have PUs between 2003 and 2013.³ PUs occur generally in patients with limited mobility due to spinal cord injury, cerebrovascular accident or hip fracture, and with cognitive impairment.^4,5

In addition, morbidity and mortality associated with PUs are serious problems. The most frequently associated diseases in hospitalised patients with PUs include pulmonary diseases (40%), followed by sepsis (26.7%) and neurological diseases (12%).⁶ Moreover, comorbidities increase the mortality risk of patients with PUs to nearly three times that of patients without a PU.⁷ In one study, 60% of patients with a PU had more than three comorbidities.⁷

Register now to continue reading

Thank you for visiting Journal of Wound Care's Silk Road Supplement and reading some of our peer-reviewed resources for healthcare professionals across Asia. To read more, please register today.

Or continue by

Signing in with your registered email address

comorbidity

incidence

mortality

pressure ulcer

prevalence

risk factors

standardised incidence rate

standardised prevalence rate

survival rate

ulcers