Medical conditions as risk factors for pressure ulcers in an outpatient setting.
OBJECTIVE
the purpose of this study was to evaluate the likelihood that the presence of certain medical conditions in older ambulatory patients are associated with the risk of developing a new pressure ulcer.


METHODS
a cohort study.


METHODS
a large outpatient record database from the United Kingdom called the General Practice Research Database.


METHODS
the frequency of disease was reported as simple percentages and the associations between the medical conditions and the development of a pressure ulcer as instantaneous rate ratios.


RESULTS
we studied 75,168 older individuals. Pressure ulcers occurred in 1,211 individuals. The medical conditions that were significantly associated with the development of a pressure ulcer after adjustment were: Alzheimer's disease, congestive heart failure, chronic obstructive pulmonary disease, cerebral vascular accident, diabetes mellitus, deep venous thrombosis, hip fracture, hip surgery, limb paralysis, lower limb oedema, malignancy, malnutrition, osteoporosis, Parkinson's disease, rheumatoid arthritis, and urinary tract infections. Angina, hypertension, and pneumonia were inversely associated with the development of a pressure ulcer.


CONCLUSIONS
it is important that physicians recognise that patients with many medical conditions may be at higher risk for pressure ulcers so that even in the ambulatory care environment appropriate prevention and detection strategies can be directed towards the patients who are most likely to benefit.
Department of Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA. dmargoli@cceb.med.upenn.edu
David J
DJ
Margolis
Jill
J
Knauss
Warren
W
Bilker
Mona
M
Baumgarten
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications; D015986:Confounding Factors, Epidemiologic; D005260:Female; D006333:Heart Failure / Q000150:complications; D006801:Humans; D008297:Male; D003668:Pressure Ulcer / Q000453:epidemiology*; D012307:Risk Factors