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Aloweni F, Gunasegaran N, Lim SH, Xin Leow BW, Agus N, Qi Goh IH, Ang SY. Socio-economic and environmental factors associated with community-acquired pressure injuries: A mixed method study. J Tissue Viability 2024; 33:27-42. [PMID: 38142199 DOI: 10.1016/j.jtv.2023.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 09/26/2023] [Accepted: 11/24/2023] [Indexed: 12/25/2023]
Abstract
AIMS To: (1) report on the prevalence of community-acquired pressure injuries (CAPIs) in patients admitted into the acute care setting; (2) examine the socio-economic and home environment associated with CAPIs; and (3) understand the challenges of caring for patients with CAPIs at home. METHODS This mixed-method study recruited patients admitted with CAPIs in the acute care hospital between March 2021 to June 2022. The hospital's pressure injury (PI) database was used to screen patients admitted with CAPIs. A purposive sample of CAPI patients and their caregivers participated in this study. A cross-sectional survey study was first performed to examine the prevalence of CAPIs and the socio-economic and home environment factors. Semi-structured interviews were conducted to understand the caregivers' challenges in caring for patients with CAPIs at home. RESULTS The CAPI prevalence was reported at 1.1 % during the study period (1039 had CAPIs out of 97 912 patients admitted to the hospital). A total of 70 caregivers and patients consented to participate in the study. The mean age of patients was 84.2 (SD = 10.4) years old; 68.6 % (n = 48) were females. Majority presented with a deep tissue injury (DTI) (37.1 %; n = 26) or unstageable PI (31.4 %; n = 22). More than half of the patients had alternating air mattresses at home (54.3 %; n = 38), and only 10 % (n = 7) had positioning wedges and used a sliding sheet for turning. The mean age of the caregivers was 43.4 years old (SD = 13.1), and 84.3 % (n = 59) were female. Continuous data were summarised using means and standard deviations, and categorical data were summarised using frequencies and percentages. Logistic regression found no significant socio-demographic and clinical predictors of patients having PI stages 2, 3, and 4 compared to patients with DTI and unstageable PI. Challenges to caring for PI at home included high financial burden, physical limitations, and personal challenges in CAPIs management. CONCLUSION CAPIs are prevalent among older patients admitted to the acute care setting. Understanding the influence of socio-economic factors is crucial for developing comprehensive strategies to mitigate the occurrence and impact of PIs. Ongoing support and education to the caregivers in the community is essential to address the reported challenges in PI care.
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Affiliation(s)
- Fazila Aloweni
- Nursing Division, Singapore General Hospital, Singapore.
| | | | - Siew Hoon Lim
- Nursing Division, Singapore General Hospital, Singapore.
| | | | - Nurliyana Agus
- Nursing Division, Singapore General Hospital, Singapore.
| | - Ivy Hui Qi Goh
- Nursing Division, Singapore General Hospital, Singapore.
| | - Shin Yuh Ang
- Nursing Division, Singapore General Hospital, Singapore.
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Lee K, Hwang J, Lee CM. The Usefulness of Present-on-Admission Data as an Indicator of Healthcare Quality Evaluation Using the Korean National Hospital Discharge in-Depth Injury Survey Data from 2006 to 2019. Risk Manag Healthc Policy 2023; 16:2309-2320. [PMID: 37953808 PMCID: PMC10637211 DOI: 10.2147/rmhp.s423555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 10/19/2023] [Indexed: 11/14/2023] Open
Abstract
Purpose Comorbidities of a principal diagnosis have varying impacts on disease and require different management depending on the onset timing. This study investigated the usefulness of present-on-admission (POA), specifically focusing on decubitus ulcers, delirium, and hypokalemia, as an indicator of healthcare quality. Patients and Methods We analyzed patient discharge data for 14 years from 2006 to 2019 using Korean National Hospital Discharge In-Depth Injury Survey (KNHDIS). Results Out of 3,231,731 discharged patients, 19,871 had secondary diagnosis codes for decubitus ulcers (n=10,390, 52.3%), delirium (n=6103, 30.7%), or hypokalemia (n=3378, 17.0%). Analysis of patients with secondary diagnoses of decubitus ulcers, delirium, or hypokalemia revealed notable differences in demographics, including gender distribution, mean age, admission route, insurance type, surgical intervention rates, mortality rates, and length of stay (LOS). Among patients with one of the top 20 principal diagnoses, those with secondary diagnoses of decubitus ulcers, delirium, or hypokalemia exhibited higher odds of surgery, increased mortality risks, and longer LOS compared to those without these secondary diagnoses. Conclusion All three of these diseases commonly occur postoperatively or during treatment and thus should be designated as potentially preventable complications that require special attention, and should also be considered as quality-of-care indicators.
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Affiliation(s)
- Kyunghee Lee
- Department of Healthcare Management, Eulji University of Korea, Seongnam, Republic of Korea
| | - Jieun Hwang
- College of Health and Welfare, Department of Health Administration, Dankook University, Cheonan, Republic of Korea
| | - Chang Min Lee
- Department of Gastroenterology, Changwon Hanmaeum Hospital, Changwon, Republic of Korea
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Kim MJ, Jeong YS, Kim HJ, Hahn HM, Thai DQ, Lee IJ. Effect of a Team Approach to Pressure Injury Management over 5 Years in a Tertiary Hospital. Adv Skin Wound Care 2023; 36:1-7. [PMID: 36537777 DOI: 10.1097/01.asw.0000902488.10296.9b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
OBJECTIVE The authors' facility established a novel integrated wound care team (IWCT), which included the implementation of a strict treatment algorithm by the patients' attending providers and a specialized wound care team led by a plastic surgeon. Investigators then retrospectively analyzed clinical outcomes of pressure injury (PI) management by the IWCT over 5 years. METHODS The authors performed a retrospective chart review and periodic statistical analysis of the data for all patients with PI referred to the IWCT in the authors' center from May 2015 to April 2019. Data including patients' demographic information, first and last consultation dates, referring department, PI stage, site of PI, and Braden Scale scores were collected and analyzed. RESULTS Patients (N = 15,556) did not differ significantly in age, sex, or Braden Scale score. A preimplementation/postimplementation analysis of PI data before and after establishing the IWCT showed that the incidence of stage 3 or 4 PIs had significantly decreased during the study period (19.1% vs 15.2%, P < .05). Conversely, the incidence of stage 1 PIs significantly increased in the same period (38.0% vs 57.4%, P < .05). The proportion of completely healed PIs also increased, and the median treatment period was significantly shortened (P < .05). CONCLUSIONS Implementation of the IWCT in a tertiary hospital setting led to a significant increase in early-stage PI detection and a decrease in severe PIs.
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Affiliation(s)
- Min Ji Kim
- In the Department of Plastic and Reconstructive Surgery, Ajou University School of Medicine, Suwon, Korea, Min Ji Kim, MD, PhD, is Clinical Assistant Professor; Yon Soo Jeong, MD, is Resident; Hee Joung Kim, RN, is Wound Care Nurse; Hyung Min Hahn, MD, is Assistant Professor; Duy Quang Thai, MD, is Graduate Resident; and Il Jae Lee, MD, PhD, is Full Professor
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Konya C, Takeuchi Y, Nakagami G, Kitamura A, Morita K, Ishizawa M, Abe Y, Higuchi H, Mizuki T, Motegi SI, Shoju S, Shimada K, Tanaka K, Kawakami S, Sanada H. Nationwide time-series surveys of pressure ulcer prevalence in Japan. J Wound Care 2022; 31:S40-S47. [PMID: 36475842 DOI: 10.12968/jowc.2022.31.sup12.s40] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The Japanese Society of Pressure Ulcers (JSPU) has two purposes: first, to improve knowledge and skills among health professionals related to preventing and managing pressure ulcers (PUs); and second, to represent those in the field managing PUs, including with government and health authorities. Since 2006, JSPU has conducted fact-finding surveys about every four years to identify PU prevalence in Japan (2006, 2010, 2013 and 2016). Based on the prevalence identified by these surveys, an attempt was made to validate the achievements of JSPU's activities. METHOD Information from one-day surveys of hospitals, long-term care health facilities, long-term care welfare facilities, and home visit nursing care stations was analysed. We used generalised estimating equations to estimate the proportions of PUs and their 95% confidence intervals (CIs) for each survey. RESULTS A total of 662,419 patients in 2631 facilities participated in the surveys. The estimated proportions for all facilities (95% CI) in chronological order, from the first to the fourth survey, were: 2.67% (2.52-2.83); 2.61% (2.43-2.80); 1.99% (1.83-2.17); and 1.79% (1.65-1.94), respectively. In all facility types, the proportion of PUs was lower in the fourth survey than the first survey. CONCLUSION The proportion of PUs showed a decreasing trend and was low according to global standards, demonstrating the efficacy of JSPU's activities.
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Affiliation(s)
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- Japanese Society of Pressure Ulcers, Tokyo, Japan
| | - Chizuko Konya
- School of Nursing, Ishikawa Prefectural Nursing University, Ishikawa, Japan
| | - Yoshinori Takeuchi
- Department of Biostatistics, School of Public Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Gojiro Nakagami
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Aya Kitamura
- Department of Nursing Administration and Advanced Clinical Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Koujiro Morita
- Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mihoko Ishizawa
- Faculty of Nursing, School of Medicine, Nara Medical University, Nara, Japan
| | - Yoshiro Abe
- Department of Plastic and Reconstructive Surgery, Graduate School of Biomedical Sciences, Tokushima University, Tokushima, Japan
| | - Hirobumi Higuchi
- Department of Plastic and Reconstructive Surgery, Iwate Prefectural Chubu Hospital, Iwate, Japan
| | - Takeo Mizuki
- Department of Nursing, Hakodate Municipal Hospital, Hokkaido, Japan
| | | | - Sawako Shoju
- Department of Nursing, Morinomiya Hospital, Osaka, Japan
| | - Kenichi Shimada
- Department of Plastic and Reconstructive Surgery, Kanazawa Medical University, Ishikawa, Japan
| | - Katsumi Tanaka
- Department of Plastic and Reconstructive Surgery, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | | | - Hiromi Sanada
- School of Nursing, Ishikawa Prefectural Nursing University, Ishikawa, Japan.,Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Búřilová P, Pokorná A, Benešová K, Mužík J, Klugar M, Krupová L, Dolanová D, Saibertová S, Beeckman D. A ten-year follow-up of the prevalence of pressure injuries in the Czech Republic: Analysis of the National Registry. Int Wound J 2022; 19:1870-1877. [PMID: 35352481 PMCID: PMC9615265 DOI: 10.1111/iwj.13793] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 02/15/2022] [Accepted: 02/21/2022] [Indexed: 02/02/2023] Open
Abstract
The study aims to follow up on the analysis of Pressure injuries (PIs) prevalence conducted between 2007 and 2014 and after the new methodological requirements for PIs surveillance establishment at the national level. A retrospective, nationwide cross-sectional analysis of data regarding the STROBE checklist was collected by the National Health Information System (NHIS). The International Classification of Diseases (ICD-10) diagnoses L89.0-L89.9 for PIs were used in the period 2010-2019. A total of 264 442 records of patients with diagnoses of L89.0-L89.9 were identified from 2010 to 2019 (26 444 patients per year on average). The numbers are increasing every year, and there is a 40% increase between 2010 and 2019. When comparing recorded PIs, the percentage of PIs occurrence in category I decreased, and the number of PIs in category IV increased in the second analysed period. Still, in absolute numbers, there is an increase across all categories. The age of patients with recorded PIs also rose slightly in the second analysed period. We have proven the PIs prevalence increase in an ageing population.
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Affiliation(s)
- Petra Búřilová
- Department of Health SciencesMasaryk University, Faculty of MedicineBrnoCzech Republic,Department of Data AnalysesInstitute of Health Information and StatisticsPragueCzech Republic,Department of Public HealthMasaryk University, Faculty of MedicineBrnoCzech Republic
| | - Andrea Pokorná
- Department of Health SciencesMasaryk University, Faculty of MedicineBrnoCzech Republic,Department of Data AnalysesInstitute of Health Information and StatisticsPragueCzech Republic
| | - Klára Benešová
- Department of Data AnalysesInstitute of Health Information and StatisticsPragueCzech Republic
| | - Jan Mužík
- Department of Health SciencesMasaryk University, Faculty of MedicineBrnoCzech Republic,Department of Data AnalysesInstitute of Health Information and StatisticsPragueCzech Republic
| | - Miloslav Klugar
- Department of Health SciencesMasaryk University, Faculty of MedicineBrnoCzech Republic,Department of Data AnalysesInstitute of Health Information and StatisticsPragueCzech Republic,Czech National Centre for Evidence‐Based Healthcare and Knowledge Translation (Cochrane Czech Republic, Czech EBHC: JBI Centre of ExcellenceMasaryk University GRADE Centre, Institute of Biostatistics and Analyses, Faculty of Medicine, Masaryk UniversityBrnoCzech Republic
| | - Lenka Krupová
- Department of DermatologyUniversity Hospital OstravaOstravaCzech Republic
| | - Dana Dolanová
- Department of Health SciencesMasaryk University, Faculty of MedicineBrnoCzech Republic,Department of Data AnalysesInstitute of Health Information and StatisticsPragueCzech Republic
| | - Simona Saibertová
- Department of Health SciencesMasaryk University, Faculty of MedicineBrnoCzech Republic
| | - Dimitri Beeckman
- Skin Integrity Research Group (SKINT), University Centre for Nursing and Midwifery, Department of Public Health and Primary CareGhent UniversityGhentBelgium,School of Health SciencesÖrebro UniversityÖrebroSweden,School of Nursing and Midwifery, Royal College of Surgeons in Ireland (RCSI)University of Medicine and Health SciencesDublinIreland,Research Unit of Plastic Surgery, Department of Clinical Research, Faculty of Health SciencesUniversity of Southern DenmarkOdenseDenmark,School of Nursing and MidwiferyMonash UniversityClaytonAustralia
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Hu B, Zhao Y, Yang J, Zeng Z, Wu Y, Gui C, Gong J, Gao Y, Yang Y, Luo C, Wang Y, Jiang Q, Guo W, Lu P, Yuan F, Li X, Dai X. Frequency of and risk factors for intensive care unit-acquired sacrum pressure injuries in critically ill patients: A multicenter cross-sectional study in China. Health Sci Rep 2021; 4:e390. [PMID: 34722934 PMCID: PMC8532509 DOI: 10.1002/hsr2.390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 08/11/2021] [Accepted: 08/20/2021] [Indexed: 12/14/2022] Open
Abstract
RATIONALE AIMS AND OBJECTIVES Hospital-acquired pressure injuries (HAPI) prolong hospital stays and are an important health problem worldwide. The aim of this study was to assess the frequency of and risk factors for intensive care unit (ICU)-acquired pressure injuries (IAPI) on the sacrum in critically ill patients in China. METHODS We performed a multicenter, cross-sectional survey of IAPI on the sacrum in 23 adult ICUs in 19 hospitals in China. Data for 421 critically ill patients were collected on December 13, 2019, and January 13, 2020, including patient characteristics, physiological, and clinical information. Logistic regression was used to analyze the risk factors for IAPI on the sacrum in the ICU. RESULTS Forty-one patients presented sacrum pressure injuries in the ICU, with a frequency of 9.74%. Risk factors that significantly increased the risk of IAPI on the sacrum were lower body mass index (BMI, odds ratio [OR] = 1.115, confidence interval [CI]: 1.011-1.229, P = .029), chronic obstructive pulmonary disease (COPD, OR = 3.183, CI: 1.261-8.037, P = .014), multiple organ dysfunction syndrome (MODS, OR = 2.670, CI: 1.031-6.903, P = .043), and a lower Braden risk score (OR = 1.409, CI: 1.197-1.659, P < .001). CONCLUSION Lower BMI, COPD, MODS, and lower Braden risk score are independent risk factors for sacrum IAPI in China.
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Affiliation(s)
- Binqin Hu
- Department of Critical Care MedicineAffiliated to the First People's Hospital of Chenzhou, University of South ChinaChenzhouChina
| | - Yang Zhao
- Department of Critical Care MedicineThe Fourth People's Hospital of ChenzhouChenzhouChina
| | - Jijun Yang
- Department of Critical Care MedicineCentral Hospital of LoudiLoudiChina
| | - Zhenhua Zeng
- Department of Critical Care MedicineNanfang Hospital, Southern Medical UniversityGuangzhouChina
| | - Yanhong Wu
- Department of Critical Care MedicineHunan Provincial People's HospitalChangshaChina
| | - Chunmei Gui
- Department of Critical Care MedicineThe First People's Hospital of ChangdeChangshaChina
| | - Jiang Gong
- Department of Intensive Care MedicineThe Third People's Hospital of LonggangShenzhenChina
| | - Yi Gao
- Department of Critical Care MedicineXiangya Boai Rehabilitation Hospital, Central South UniversityChangshaChina
| | - Yong Yang
- Department of Critical Care MedicineChangsha Central Hospital, University of South ChinaChangshaChina
| | - Cuizhu Luo
- Department of Critical Care MedicineJiangXi Pingxiang People's HospitalPingxiangChina
| | - Yu Wang
- Department of Critical Care MedicineThe Third People's Hospital of YongzhouYongzhouChina
| | - Qingjuan Jiang
- Department of Critical Care Medicinethe First Affiliated Hospital, Hunan College of Traditional Chinese MedicineZhuzhouChina
| | - Wenlong Guo
- Department of Critical Care MedicineThe First People's Hospital of YueyangYueyangChina
| | - Pan Lu
- Department of Critical Care MedicineThe Sixth Affiliated Hospital, Sun Yat‐sen UniversityShenzhenChina
| | - Fen Yuan
- Department of Critical Care MedicineThe Second People's Hospital of ShenzhenShenzhenChina
| | - Xiaofang Li
- Department of OstomyAffiliated to the First People's Hospital of Chenzhou, University of South ChinaChenzhouChina
| | - Xingui Dai
- Department of Critical Care MedicineAffiliated to the First People's Hospital of Chenzhou, University of South ChinaChenzhouChina
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Kwak C, Ko Y. Influencing factors of pressure injury healing in an acute care setting: A retrospective cohort study. J Tissue Viability 2021; 31:152-157. [PMID: 34758923 DOI: 10.1016/j.jtv.2021.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 10/30/2021] [Accepted: 11/04/2021] [Indexed: 10/19/2022]
Abstract
AIM This study aimed to investigate the factors that influence healing during acute care hospitalization by examining the differences in pressure injury (PI) status between admission and discharge. MATERIAL AND METHODS A total of 371 patients who met the study's inclusion criteria were divided into two groups (aggravated or improved) based on the PI status observed at admission and discharge. We used bivariate analyses to compare demographics and clinical factors associated with wound severity and aggravation/improvement of wound condition. Using multiple logistic regression, we identified and examined independent predictors for significant association with aggravation/improvement of the wound status. RESULTS The prevalence rate of PI at acute hospital admission was 12.5%. By the time of discharge, only 5.4% of PI patients had improved PI, whereas 12.6% had aggravated PI. The significant aggravating factors of PI during acute care hospitalization were the patient's consciousness level, use of foley catheter, creatinine level, and Braden Scale scores (p < .05). Residential place prior to admission were found to be associated with the healing. CONCLUSIONS Nurses providing prophylactic management require close attention to patients who are admitted from long-term facilities to prevent aggravation of PI during acute care hospitalization.
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Affiliation(s)
- Chanyeong Kwak
- School of Nursing, Hallym University, Hallymdaehak-gil, Chuncheon, Gangwon-do, 24252, South Korea.
| | - Young Ko
- College of Nursing, Gachon University, 191 Hambakmoeiro, Yeonsu-Gu, Incheon, 21936, Republic of Korea.
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Zhang Z, Jiang Z, Wu Y, Yan Y, Chen W, Zeng Y. Comparing the Interface pressure distribution of the full body chest-lumbar cushion made of memory cotton with the traditional chest cushion. BMC Musculoskelet Disord 2021; 22:839. [PMID: 34592978 PMCID: PMC8485509 DOI: 10.1186/s12891-021-04668-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 08/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pressure injuries are common complications occurred duration hospitalization, whether the interface pressure distribution in full body memory cotton chest-lumbar cushion was superior than traditional chest cushion remains unclear. PURPOSE This study aimed to compare the effects that the full body memory cotton chest-lumbar cushion versus traditional chest cushion on interface pressure. METHODS A total of 66 healthy individuals were recruited. The volunteers were placed in the left lateral position and left armpit and iliac spine pressure and level of comfort were measured. Group differences were assessed using the paired t-test or Wilcoxon test according to data distribution. Additionally, multivariate regression analysis was applied to determine the potential role of sex, age, and body mass index on left armpit and iliac spine pressure and overall comfort. RESULTS Compared with the traditional chest cushion, we noted that the full body chest-lumbar cushion made of memory cotton was associated with less pressure on the left armpit (38.17 ± 10.39 mmHg vs. 67.93 ± 14.67 mmHg, respectively; P < 0.0001) and iliac spine (43.32 ± 13.70 mmHg vs. 50.77 ± 20.94 mmHg, respectively; P = 0.0004). Moreover, we noted that the overall comfort with the memory cotton chest-lumbar cushion was higher than that with the traditional chest cushion (8.48 ± 1.08 vs. 6.36 ± 1.45, respectively; P < 0.0001). Finally, the multivariate regression analyses found iliac spine pressure could affect by sex (P = 0.0377) and body mass index (P = 0.0380). CONCLUSIONS The full body chest-lumbar cushion made of memory cotton had beneficial effects on left armpit and iliac spine pressure and on comfort. These findings should be applied to future clinical practice.
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Affiliation(s)
- Zhiwei Zhang
- Department of Operating Room, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Zhiqun Jiang
- Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ying Wu
- Department of Operating Room, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yu Yan
- Department of Operating Room, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Weiqiang Chen
- Department of Operating Room, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yu Zeng
- Department of Operating Room, The First Affiliated Hospital of Nanchang University, Nanchang, China.
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Association between socioeconomic position and diabetic foot ulcer outcomes: a population-based cohort study in South Korea. BMC Public Health 2021; 21:1395. [PMID: 34261483 PMCID: PMC8281670 DOI: 10.1186/s12889-021-11406-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 06/21/2021] [Indexed: 01/13/2023] Open
Abstract
Background Low socioeconomic position (SEP) is associated with a high incidence of diabetic foot ulcers (DFUs). However, reports on the association between SEP and DFU outcomes are limited. Therefore, in this study, we investigated this association and determined the prognostic factors of DFU outcomes. Methods The total cohort comprised 976,252 individuals. Using probability sampling, we randomly selected a sample of patients by reviewing the data from the Health Insurance Review and Assessment Service database of South Korea during 2011–2015. Residence, household income, and insurance type represented SEP. The primary outcome was amputation, and the secondary outcome was mortality. A multivariate model was applied to identify the predictive factors. Amputation-free survival and overall survival were calculated using the Kaplan-Meier method. Results Among 976,252 individuals in the cohort, 1362 had DFUs (mean age 62.9 ± 12.2 years; 42.9% were women). Overall amputation and mortality rates were 4.7 and 12.3%, respectively. Male sex (hazard ratio [HR], 2.41; p < 0.01), low SEP (HR 5.13, 5.13; p = 0.018), ophthalmopathy (HR, 1.89; p = 0.028), circulatory complications (HR, 2.14; p = 0.020), and institutional type (HR, 1.78; p = 0.044) were prognostic factors for amputation. Old age (HR, 1.06; p < 0.01), low SEP (HR, 2.65; p < 0.01), ophthalmopathy (HR, 1.74; p < 0.01), circulatory complications (HR, 1.71; p < 0.01), and institution type (HR 1.84; p < 0.01) were predictors of mortality. Conclusions DFU patients with a low SEP are strongly associated with increased amputation and mortality rates. Along with age and comorbidities, SEP could provide the basis for risk assessment of adverse outcomes in DFU. Providing targeted care for this population considering SEP may improve the prognosis.
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Abstract
A pressure ulcer is defined as localized ischemic skin or soft tissue damage resulting from disruption of the blood supply by pressure over the bony prominence. However, it is not just a wound that causes pain to individuals, but also a complex disease that causes socioeconomic losses. In 2019, total 30,983 patients with pressure ulcers were treated at medical institutions in Korea, and 76 billion Korean won (KRW) was spent on this treatment. Inpatient care cost amounted to 65.5 billion KRW, whereas outpatient care cost amounted to 9.8 billion KRW. The average hospitalization cost per patient was 6,696,605 KRW, and the average hospitalization period was 57.4 days, averaging 116,707 KRW per patient per day. The average outpatient care cost per patient was 421,134 KRW, and the average period in the clinic was 8.9 days, calculated at 47,428 KRW per day. The development of pressure ulcers inevitably causes socioeconomic losses and puts strain on limited medical resources; therefore, the best socioeconomic solution is prevention. Prevention has been shown to be much more efficient in cost-effective studies on treatment and prevention. Therefore, investment of more resources to prevent the development of pressure ulcers is the best solution to reduce the related socioeconomic burden.
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Geng J, Yang KL, Cai YT, Shi JY, Yin M, Wang XP. Appraisal and recommendation synthesis of guidelines and consensuses for interventions of pressure ulcers: A protocol for systematic review. Medicine (Baltimore) 2020; 99:e20417. [PMID: 32481344 PMCID: PMC7249905 DOI: 10.1097/md.0000000000020417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Pressure ulcers (PU) bring a considerable physical and mental burden on patients and their families, and have put families and government under tremendous pressure to cover the cost for treatment. Therefore, this protocol proposes to evaluate the quality of existing PU clinical practice guidelines (CPGs) and compare the similarities and differences between its recommendations in order to improve the treatment efficacy and reduce the PU treatment cost. METHODS Electronic databases and specific databases of CPGs will be searched. Study selection and data collection will be performed independently by two reviewers. The Appraisal of Guidelines for Research & Evaluation II (AGREE II) Instrument and Reporting Items for Practice Guidelines in Healthcare (RIGHT) will be used to assess the methodological quality and reporting quality of included CPGs. Bubble plot will be used to describe the difference of the quality, and mind mapping will be plotted to illustrate the comparison of recommendations of a guideline when needed. R software, MindMaster and Excel will be used. RESULTS The results of this study will be submitted to a peer-reviewed journal for publication. CONCLUSION This systematic review will provide comprehensive evidence of CPGs of PU. PROSPERO REGISTRATION NUMBER CRD42020149176.
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Affiliation(s)
- Jie Geng
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University
- The Second Hospital of Lanzhou University
| | - Ke-Lu Yang
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University
| | - Yi-Tong Cai
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University
| | - Ji-Yuan Shi
- Evidence-Based Nursing Center, School of Nursing, Lanzhou University
| | - Min Yin
- The First Hospital of Lanzhou University, Lanzhou
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Jun D, Choi H, Kim J, Lee M, Kim S, Jo D, Kim C, Shin D. Efficacy of the Mobile Three-Dimensional Wound Measurement System in Pressure Ulcer Assessment. ACTA ACUST UNITED AC 2019. [DOI: 10.22467/jwmr.2019.00829] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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