Impact of Pressure Injuries on Patient Outcomes in a Korean Hospital

Abstract

PURPOSE: The purpose of this study was to compare the effect of pressure injuries on mortality, hospital length of stay, healthcare costs, and readmission rates in hospitalized patients. DESIGN: A case-control study. SUBJECTS AND SETTING: The sample comprised 5000 patients admitted to a tertiary hospital located in Seoul Korea; 1000 patients with pressure injuries (cases) were compared to 4000 patients who acted as controls. METHODS: We retrospectively extracted clinical data from electronic health records. Study outcomes were mortality, hospital length of stay, healthcare costs, and readmission rates. The impact of pressure injuries on death and readmission was analyzed via multiple logistic regression, hospital deaths within 30 days were analyzed using the survival analysis and Cox proportional hazards regression, and impact on the length of hospitalization and medical costs were analyzed through a multiple linear regression. RESULTS: Developing a pressure injury was significantly associated with an increased risk of in-hospital mortality (odds ratio [OR], 3.94; 95% confidence interval [CI], 2.91-5.33), 30-days in-hospital mortality (OR, 2.18; 95% CI, 1.59-3.00), and healthcare cost (β = 11,937,333; P < .001). Pressure injuries were significantly associated with an extended length of hospitalization (β = 20.84; P < .001) and length of intensive care unit (ICU) stay (β = 8.16; P < .001). Having a pressure injury was significantly associated with an increased risk of not being discharged home (OR, 5.55; 95% CI, 4.35-7.08), along with increased risks of readmission (OR, 1.30; 95% CI, 1.05-1.62) and emergency department visits after discharge (OR, 1.70; 95% CI, 1.29-2.23). CONCLUSIONS: Development of pressure injuries influenced mortality, healthcare costs, ICU and hospital length of stay, and healthcare utilization following discharge (ie, readmission or emergency department visits). Hospital-level efforts and interdisciplinary approaches should be prioritized to develop interventions and protocols for pressure injury prevention.

<p>The Effect of Using Olive Oil and Fish Oil Prophylactic Dressings on Heel Pressure Injury Development in Critically Ill Patients</p>

“…1,2 These ulcers can be associated with various issues for the patient and the healthcare system including an increase in the costs, whether during hospitalization or after hospital discharge, an increase in the length of stay in hospital, and an increase in the need for readmission. 3 In addition, the development of pressure injuries in a patient can lead to psychological problems, lower self-esteem, and lower quality of life. 4,5 Excessive pressure on the capillaries of the skin and their blockage are the main causes of pressure injuries development.…”

An exploratory study of risk factors for pressure injury in patients undergoing spine surgery

“…Pressure injury can cause prolonged hospitalization. Han et al [22] reported that pressure injuries influenced mortality (OR 2.18) and increased the risk of increased hospital stay (OR 5.55), along with increased risk of readmission (OR 1.30) and emergency department visits after discharge (OR 1.70). Analysis of the association between pressure injury and medical costs requires further research using substantial data.…”

Comparative Evaluation of the Effect of Aloe Vera Gel, Olive Oil, and Compound Aloe Vera Gel-Olive Oil on Prevention of Pressure Ulcer

“…[ 5 6 ] The incidence of these wounds in the ICU of South Korean hospitals was 5.9%. [ 7 ] In Iran, the prevalence of PUs was reported to be 5% in general wards and 21%–1.10% in the ICUs. [ 2 ] One of the major health problems is PU leading to increased hospitalization time, pain, infection, chronic wounds, sepsis, and death.…”