Prevalence, incidence, management, and predictors of venous ulcers in the long-term-care population using the MDS.
OBJECTIVE
To describe the prevalence, incidence, management, and predictors of venous ulcers in residents of certified long-term-care facilities using the Minimum Data Set.


METHODS
Retrospective cohort study.


METHODS
32,221 residents admitted to long-term-care facilities in Missouri between January 1, 1996, and October 30, 1998.


METHODS
Version 2.0 of the Minimum Data Set was utilized. Assessment items included selected measures from background information, disease diagnoses, physical functioning and structural problems, health conditions, oral/nutritional status, and skin condition.


RESULTS
Venous ulcer prevalence on admission was 2.5%. The incidence of venous ulcer development for long-term-care residents admitted without an ulcer at 90, 180, 270, and 365 days after admission was 1.0%, 1.3%, 1.8%, and 2.2%, respectively. The most frequent skin treatments for residents with a venous ulcer were ulcer care, dressings, and ointments. Factors associated with venous ulcer development within a year of admission were diabetes mellitus, peripheral vascular disease, and edema.


CONCLUSIONS
Venous ulcer prevalence and incidence are greater in the long-term-care population than in the community at-large. Residents with a venous ulcer are likely to have comorbid conditions such as diabetes mellitus, peripheral vascular disease, congestive heart failure, edema, wound infection, and pain. Based on these data, risk factors such as history of leg ulcers, recent edema, diabetes mellitus, congestive heart failure, or peripheral vascular disease should prompt clinicians to carefully plan care that will manage a resident's risk for venous ulcer development.
Wipke-Tevis
D D
DD
Rantz
M J
MJ
Mehr
D R
DR
Popejoy
L
L
Petroski
G
G
Madsen
R
R
Conn
V S
VS
Grando
V T
VT
Porter
R
R
Maas
M
M
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003625:Data Collection; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D015994:Incidence; D008297:Male; D008484:Medicaid; D006278:Medicare; D008875:Middle Aged; D008923:Missouri / Q000453:epidemiology; D009730:Nursing Assessment; D011237:Predictive Value of Tests; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012866:Skilled Nursing Facilities; D014481:United States; D014647:Varicose Ulcer / Q000453:epidemiology / Q000209:etiology* / Q000451:nursing