The Epidemiology of Pressure Ulcer in Germany: Systematic Review

Abstract

Pressure ulcers are considered as indicators of the quality of care. The aim of this study was to provide a systematic review of the incidence and prevalence of pressure ulcers in Germany between 2010 and 2015. The databases PubMed, CINAHL, DIMDI, Web of Science, LIVIVO, Google, Google Scholar, as well as the publishers Springer and the Thieme were searched until the end of February 2016. The extracted data were monitored by two reviewers. A risk of bias assessment was conducted. 219 epidemiologic figures were found in 67 studies and documents. Most data were identified for the hospital setting. The majority of figures in long-term care was based on primary research. Considering sources of high methodological quality, prevalence in long-term care varied between 2% and 5% and between 2% to 4% in hospitals (category 2 and above). Routine data collections showed heterogeneous results from the hospital settings with prevalence from 0.07% to 4.37%. No incidence figures and no routine data collections were identified for ambulatory settings. Prevalence varied between 2 and 4% (including category 1). Review results indicate that pressure ulcers are frequent within all health care settings in Germany. Disregarding methodological limitations, pressure ulcer prevalence is between 2% and 5% in long-term care patients. Due to the heterogeneity of the available data, generalizable statements are not possible for the hospital settings. Pressure ulcer prevalence is most likely at least 2%. Results indicate that pressure ulcer preventive measures need to be improved in Germany.