Pres­sure injuries prevention is better than solv­­ing of their complications

Abstract

Aim: Target of this study was to analyse occurrence of pressure ulcers (PUs) in patients hospitalized at First Department of Surgery of St. Anne’s University Hospital between 2015 and 2017, identify their dependency on neurological comorbidities. Especially in group of eight patients with developed position PUs to analyse the possibility to influence their origin. Methodology: Retrospective analysis of the data from the hospital information system and an electronic tool (i-hojeni.cz). Statistical analysis was carried out by means of Pearson’s chi-square test, level of significance 0.05. Results: In the period 2015– 2017 in total 9,550 patients out of 11,028 hospitalized patients underwent surgery. The PUs developed during hospitalization in 115 hospitalized patients (62 women and 53 men), out of which 104 underwent surgery. Average age of these patients was 81.61 (36– 97) years of age, the average body mass index (BMI) was 24.93 and average length of hospitalization was 23.4 days. The time between admission to hospital and surgery was 2.82 (0– 16) days. On average, there occurred 1.41 PUs per patient. The most frequent location of PUs were heels and buttocks. We found no statistically significant relation between BMI and occurrence of PUs (p > 0.05). On the contrary, the patients’ age and length of hospitalization related to the occurrence of PUs (p < 0.05). We proved non-statistic relation between development of pressure ulcer in operated patients and existence of neurological anamnesis. In total, 15 patients died, nevertheless 9 of them died with symptoms of sepsis with no direct relation to the PU lesions. A special group of evaluated patients were eight patients who had PUs after position trauma. The six of them died (75%) of septic development due to PUs. Conclusion: In spite of all preventive measure, PUs develop in surgically treated patients, especially those with neurological diseases in patient history (71.30%). Measures preventing development of PUs need to be applied not only in hospitals and institutes of social care but also in home care. Consequences of falls – especially of elderly with frequently insufficient social background may be ultimately fatal.