PMID- 33325127
OWN - NLM
STAT- MEDLINE
DCOM- 20210701
LR  - 20210701
IS  - 1365-2702 (Electronic)
IS  - 0962-1067 (Linking)
VI  - 30
IP  - 5-6
DP  - 2021 Mar
TI  - Stage-related implications of community-acquired pressure injuries for the acute 
      medical inpatients.
PG  - 712-724
LID - 10.1111/jocn.15598 [doi]
AB  - AIMS: To analyse the prevalence of any-stage pressure injuries at hospital 
      admission and their impact on short-, mid- and late-term mortality. Patient 
      characteristics associated with pressure injuries and the impact on hospital 
      costs were also investigated. BACKGROUND: In medical patients acutely admitted to 
      hospital, no study analysed the presence of pre-existing pressure injuries and 
      the related short- and long-term mortality according to the overall stages of 
      severity thereof. DESIGN: Retrospective cohort study following the STROBE 
      guideline. METHODS: In a population of 7217 acute medical inpatients, the 
      presence and staging of pressure injuries were assessed at hospital admission. 
      The impact of pressure injury on 30-, 180- and 365-day mortality was analysed by 
      multivariate Cox regression models. RESULTS: The prevalence of community-acquired 
      pressure injuries was 14.9% (stage-1: 8.1%; stage-2: 3.5%; stage-3: 1.6%; 
      stage-4: 1.1%; unstageable: 0.5%). Hemiplegia/paraplegia, anaemia, poor 
      functional status, high nutritional risk, clinical instability and systemic 
      inflammatory response, but not hydration status, were found to be associated with 
      the occurrence of stage-2-and-above pressure injuries. An increasing difference 
      was found in Diagnosis-Related Groups (DRG) weight according to pressure injury 
      stages. A distinct and progressively increasing risk-of-death for any-stage 
      pressure injury was shown after 365-days. A significantly increased mortality 
      risk for all considered time intervals was found for unstageable and stage-4 
      pressure injuries. CONCLUSIONS: In acute medical inpatients, the presence of 
      community-acquired pressure injuries is part of a multidimensional clinical 
      complexity. The presence and staging of pressure injuries have an independent 
      dramatic impact on of early-to-late mortality and hospital costs. RELEVANCE TO 
      CLINICAL PRACTICE: This study documented as community-acquired pressure injuries 
      are highly prevalent and represents an independent predictor of outcomes in 
      strict dependence of the progression of thereof stage. The presence of 
      community-acquired pressure injuries should be interpreted as a critical marker 
      of frailty and increased vulnerability.
CI  - (c) 2020 John Wiley & Sons Ltd.
FAU - Sanson, Gianfranco
AU  - Sanson G
AUID- ORCID: 0000-0001-8319-635X
AD  - School of Nursing, Clinical Department of Medical, Surgical and Health Sciences, 
      University of Trieste, Trieste, Italy.
FAU - Barbin, Ilaria
AU  - Barbin I
AD  - School of Nursing, Clinical Department of Medical, Surgical and Health Sciences, 
      University of Trieste, Trieste, Italy.
FAU - De Matteis, Daniela
AU  - De Matteis D
AD  - Internal Medicine Department, University Hospital, Trieste, Italy.
FAU - Marzinotto, Ilaria
AU  - Marzinotto I
AD  - School of Nursing, Clinical Department of Medical, Surgical and Health Sciences, 
      University of Trieste, Trieste, Italy.
FAU - Zanetti, Michela
AU  - Zanetti M
AUID- ORCID: 0000-0002-2634-6363
AD  - Internal Medicine Department, University Hospital, Trieste, Italy.
LA  - eng
PT  - Journal Article
DEP - 20201228
PL  - England
TA  - J Clin Nurs
JT  - Journal of clinical nursing
JID - 9207302
MH  - Acute Disease/therapy
MH  - Hospitalization
MH  - Humans
MH  - *Inpatients
MH  - *Pressure Ulcer/epidemiology
MH  - Prevalence
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Comorbidity
OT  - DRG weight
OT  - hydration
OT  - inflammation
OT  - mortality
OT  - nursing
OT  - nutrition
OT  - pressure injuries
OT  - stages
EDAT- 2020/12/17 06:00
MHDA- 2021/07/02 06:00
CRDT- 2020/12/16 05:41
PHST- 2020/11/12 00:00 [revised]
PHST- 2020/08/21 00:00 [received]
PHST- 2020/12/04 00:00 [accepted]
PHST- 2020/12/17 06:00 [pubmed]
PHST- 2021/07/02 06:00 [medline]
PHST- 2020/12/16 05:41 [entrez]
AID - 10.1111/jocn.15598 [doi]
PST - ppublish
SO  - J Clin Nurs. 2021 Mar;30(5-6):712-724. doi: 10.1111/jocn.15598. Epub 2020 Dec 28.