The Impact of COVID-19 on Rates of Pressure Injuries Among Hospitalized Patients across the US.

Abstract

To determine the impact of the COVID-19 pandemic on hospital-acquired pressure injury (HAPI) rates and composition of HAPI stages among hospitalized patients across the US. Using encounter-level data from a nationwide healthcare insurance claims database, the authors conducted a retrospective cohort study and an interrupted time-series analysis to determine HAPI rates among hospitalized patients within 90 days of admission before (January 2018 to February 2020) and after (March 2020 to December 2020) the onset of the COVID-19 pandemic. Of 3,418,438 adult patients assessed for inclusion in the study, 1,750,494 met the inclusion criteria. Outcomes measured included the presence of a HAPI within 90 days of admission and HAPI stage based on the International Classification of Diseases, 10th Revision diagnosis codes. The authors identified HAPIs in 59,175 episodes of care, representing 59,019 unique patients and corresponding to an overall HAPI rate of 2.65%. Baseline characteristics did not vary significantly across the two time periods. Further, HAPI rates were consistent across the time periods analyzed with no significant differences in rates following the onset of the pandemic (P = .303). Composition of HAPI stages remained consistent across the pandemic (unspecified, stages 1-4, Ps = .62, .80, .22, .23, and .52, respectively) except for a significant decrease in unstageable/deep tissue pressure injuries (-0.088%, P = .0134). Although hospital resources were strained at the peak of the COVID-19 pandemic, no differences were identified in HAPI rates among the study's cohort of privately insured patients.