Risk Factors for Pressure Ulcers

BACKGROUND: Pressure ulcers (PrUs) remain a common problem in all healthcare settings. The aim of this study was to assess the presence of risk factors in patients with PrUs. METHODS: The study included 32 immobilized inpatients with PrUs and 30 immobilized inpatients without PrUs as a control group, who were being followed up at the Ankara Physical Therapy and Rehabilitation Hospital, Ankara, Turkey. Patients were given physical examinations and assessed for medical history, as well as for associated diseases, the duration of PrUs, the presence of stool and urinary incontinence, the use of pressure-reducing bed surface, and change of position. Routine biochemical and hematologic blood examinations were performed in all of the patients involved in the study. RESULTS: When risk factors for PrUs were assessed, 81.2% of the patients with PrUs had stool and urine incontinence, 46.8% had been smoking, 46.8% had hypoalbuminemia, 15.6% had been drinking alcohol, and 9.3% had diabetes; 18.7% had been using a pressure-reducing bed surface before the ulcer appeared, and 40.6% started to use a pressure-reducing bed surface after the ulceration occurred; and 59.3% were repositioned periodically. PrUs were found to develop earlier in patients who were smoking and who had anemia. A significant relation also was found between the grade of the ulcer and the frequency of change of position in bed. Smoking and urinary/stool incontinence were found to be significantly present more frequently in the patient group than the control group. Stool incontinence and the absence of the use of a pressure-reducing bed were also found to be risk factors in the patient group when compared with the control group. CONCLUSIONS: The authors believe that stool and urinary incontinence, smoking, anemia, not using a pressure-reducing bed surface, and infrequent change of position in bed are considerable risk factors for the development of PrUs. Immobilized patients should be assessed for these risk factors, and measures should be taken to prevent PrU development. ADV SKIN WOUND CARE 2009;22:412-5