Older adult patients with out-of-hospital pressure injuries: a single-center retrospective study in a tertiary hospital in China
TL;DR
The prevalence of preexisting PIs among older adult patients admitted to tertiary hospitals is high, with delayed treatment and limited awareness among home caregivers, and strengthening wound care and preventive quality management through hospital-based platforms may be associated with improve healing outcomes.
Abstract
Background To investigate the prevalence and clinical characteristics of pressure injuries (PIs) present at hospital admission among older adult patients, and to identify factors influencing healing outcomes through a single-center retrospective analysis. The goal is to inform nursing strategies for PI management in older adults. Methods Data were retrieved from a self-developed pressure injury prevention and management platform at a tertiary hospital in Zhejiang Province. Patients aged ≥60 years admitted between January 2022 and December 2023 with preexisting PIs were included. Data on demographics, medical conditions, PI onset timing, staging, and outcomes were collected. Univariate analysis was performed using healing status as the outcome variable, followed by logistic regression to identify associated factors. Results In total, 30,811 older adult patients with PIs were included, representing 10.89% of all admissions. Males accounted for 63% and females 37%. In 85% of cases, PIs originated in the home, and 71.80% involved multiple sites. Only 44 patients (0.14%) were admitted specifically for PI treatment. The sacrococcygeal region was the most common site (22.67%). Overall, 49.08% of cases were Stage 1 PIs, while 41.70% were Stage 3 or higher. The overall healing rate was 21.90%. Multivariate regression analysis identified sex, disease type, PI onset timing, Braden score, and hospital length of stay as significant predictors of healing outcomes. Conclusion The prevalence of preexisting PIs among older adult patients admitted to tertiary hospitals is high, with delayed treatment and limited awareness among home caregivers. Strengthening wound care and preventive quality management through hospital-based platforms may be associated with improve healing outcomes. There is an urgent need for post-discharge care and education. Leveraging tertiary hospital expertise to deliver internet-based nursing services or empower primary care providers in PI prevention and wound care is suggested as a potential strategy to enhance quality of life for older adult patients in home and rehabilitation settings. However, these hypotheses require validation through prospective interventional studies.