Clinical evaluation with long-term follow-up of patients with pressure ulcers in one Swedish county.

Abstract

To conduct a screening, skin examination and risk assessment of patients with pressure ulcers (PUs) in one Swedish county (inpatient, primary and community care) with follow-up after six months to investigate ulcer healing, frequency of amputation and mortality rate linked to preventive measures. The methodology recommended by the European Pressure Ulcer Advisory Panel was used. Screening, risk assessment and skin examination were performed during March 2017. The modified Norton scale was used to assess PU risk, with a score of ≤20 indicating presence of risk. A research questionnaire was used to document prevention and treatment. Follow-up was performed after six months, during September 2017. The same research questionnaire was used to capture the current situation of the patients, including ulcer healing, frequency of amputation, and mortality rate. Screening covered 464 patients: 303 hospitalised, 68 in community care, and 93 in primary care. A total of 110 patients-55 at risk of PU and 55 with PUs, the majority of which were category 2-4 PUs-were included in the study. At follow-up, 67% were treated in community care, 32% in primary care, and 1% in hospital. Mortality rate for patients with PUs was 44%. Of the remaining 31 patients, 17 had unhealed PUs, 10 had healed PUs, two had undergone amputation, and complete follow-up data was missing in the remaining two patients. These results reflect the complex situation of an aged and frail patient group, including a lack of preventive measures and follow-up routines in community and primary care.