Pressure ulcers and the transition to long-term care.
OBJECTIVE
To estimate the prevalence of pressure ulcers among newly admitted residents of long-term-care facilities and to determine whether patients admitted from hospitals had a higher prevalence than those admitted from home or other settings.


METHODS
Prospective cohort study conducted between 1992 and 1995.


METHODS
59 long-term-care facilities in Maryland.


METHODS
2015 residents aged 65 years and older newly admitted to participating long-term-care facilities.


METHODS
Stage II, III, or IV pressure ulcer, first mentioned in the long-term-care facility's chart within 2 days of admission.


RESULTS
Of the 2015 residents studied, 208 (10.3%) had 1 or more pressure ulcers on admission to a long-term-care facility. The proportion of patients with 1 or more pressure ulcers was 11.9% among those admitted from a hospital and 4.7% among those not admitted from a hospital (P<.001). In multivariable analysis, admission from a hospital was significantly associated with pressure ulcer prevalence on admission (odds ratio, 2.2; 95% confidence interval, 1.3-3.7). A lower prevalence of pressure ulcers on admission was significantly associated with being white; a higher prevalence was associated with being chairbound or bedridden, being underweight, and having fecal incontinence.


CONCLUSIONS
Admission to a long-term-care facility from a hospital is an important marker for higher pressure ulcer risk. The identification of pressure ulcer risk factors is essential to the implementation of prevention activities, ensuring that appropriate interventions are targeted to the residents who are most likely to benefit.
Baumgarten
Mona
M
Department of Epidemiology and Preventive Medicine, University of Maryland, Baltimore, MD, USA.
Margolis
David
D
Gruber-Baldini
Ann L
AL
Zimmerman
Sheryl
S
German
Pearl
P
Hebel
J Richard
JR
Magaziner
Jay
J
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003704:Dementia / Q000150:complications; D005242:Fecal Incontinence / Q000150:complications; D005260:Female; D015577:Geriatric Assessment; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008396:Maryland / Q000453:epidemiology; D015999:Multivariate Analysis; D010360:Patient Transfer / Q000706:statistics & numerical data*; D011159:Population Surveillance; D003668:Pressure Ulcer / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012866:Skilled Nursing Facilities / Q000706:statistics & numerical data*; D014549:Urinary Incontinence / Q000150:complications