Prevalence of decubitus ulcer and associated risk factors in an institutionalized Spanish elderly population

Abstract

OBJECTIVE: We investigated the prevalence and associated risk factors of decubitus ulcer in an institutionalized Spanish elderly population. METHODS: A 1 d cross-sectional study in 50 Spanish geriatric facilities was carried out. Data collection included age, sex, body mass index, presence of decubitus ulcer, duration of ulcer, days of hospitalization, risk according to the Norton scale, associated risk factors, and nutrition status evaluation including assessment according to the Nutrition Screening Initiative. Logistic regression analysis calculated prevalence and association with risk factors. RESULTS: Data from 827 elderly people (71.3% female) were collected. Mean age (± standard deviation) was 82.4 (±8.0) y. Decubitus ulcer prevalence was 35.7%, with no sex differences (34.1% males and 37.2% females). Body mass index was inversely associated with ulcer prevalence in a statistically significant way (odds ratio = 0.94, 95% confidence interval = 0.92–0.97), but the following were risk factors: age (1.03, 1.01–1.06), previous ulcer (3.09, 2.16–4.04), diabetes (1.54, 1.02–2.51), functionality (2.91, 2.05–4.12), immobility (8.30, 5.09–11.51), erythema (12.12, 7.46–16.78), dehydration (2.09, 1.31–2.87), and edema (2.35, 1.64–3.06). Subjective evaluation of nutrition status and nutrition status as assessed by the Nutrition Screening Initiative Determine scale (modified) showed a significant linear association with ulcer ( P < 0.001), and a score above 14 points in the modified Norton scale was associated with a lower ulcer rate ( P < 0.001). CONCLUSIONS: Prevalence of decubitus ulcer in the Spanish elderly population increased with age, poor nutrition status, immobilization, and impaired functionality.