Agency News and Notes

Pressure ulcers are increasing among hospital patients

Hospitalizations involving patients with pressure ulcers developed either before or after admission increased by nearly 80 percent between 1993 and 2006, according to data from the Agency for Healthcare Research and Quality (AHRQ). Pressure ulcers, also called bed sores, typically occur among patients who can't move or have lost sensation. Prolonged periods of immobility put pressure on the skin, soft tissue, muscle, or bone, causing ulcers to develop. Older patients, stroke victims, people who are paralyzed, or those with diabetes or dementia are particularly vulnerable. Pressure ulcers may indicate poor quality of care at home, in a nursing home, or in a hospital. Severe cases can lead to life-threatening infections.

AHRQ's analysis found 503,300 pressure ulcer-related hospitalizations in 2006. In addition:

• Pressure ulcers were the primary diagnosis in about 45,500 hospital admissions—up from 35,800 in 1993.
• Pressure ulcers were a secondary diagnosis in 457,800 hospital admissions—up from 245,600 in 1993. These patients, admitted primarily for pneumonia, infections, or other medical problems, either developed pressure ulcers before or after admission.
• Among hospitalizations involving pressure ulcers as a primary diagnosis, about 1 in 25 admissions ended in death. The death rate was higher when pressure ulcers were a secondary diagnosis—about 1 in 8.
• Pressure ulcer-related hospitalizations are longer and more expensive than many other hospitalizations. While the overall average hospital stay is 5 days and costs about $10,000, the average pressure ulcer-related stay extends to between 13 and 14 days and costs between $16,755 and $20,430, depending on medical circumstances.

For more information, go to Hospitalizations Related to Pressure Ulcers Among Adults 18 Years and Older, 2006, HCUP Statistical Brief #64. The report uses statistics from the 2006 Nationwide Inpatient Sample, a database of hospital inpatient stays that is nationally representative of inpatient stays in all short-term, non-Federal hospitals. The data are drawn from hospitals that comprise 90 percent of all discharges in the United States and include all patients, regardless of insurance type, as well as the uninsured.

Editor's Note: AHRQ has developed a program for pressure ulcer prevention in nursing homes and is funding research on pressure ulcer prevention in hospitals. For more information about the nursing home program, go to http://www.ahrq.gov/research/ontime.htm.

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