Immobility--a major risk factor for development of pressure ulcers among adult hospitalized patients: a prospective study.
OBJECTIVE
To identify risk factors associated with pressure ulcer development among adult hospitalized medical and surgical patients.


METHODS
A prospective comparative study including 530 adult patients from medical and surgical wards. Registered Nurses made the data collection on admission and once a week for up to 12 weeks. The risk assessment scale used was the Risk Assessment Pressure Sore (RAPS) scale, including the following variables; general physical condition, activity, mobility, moisture, food intake, fluid intake, sensory perception, friction and shear, body temperature and serum albumin.


RESULTS
Sixty-two (11.7%) patients developed 85 pressure ulcers. The most common pressure ulcer was that of nonblanchable erythema. Patients who developed pressure ulcers were significantly older, hospitalized for a longer time, had lower scores on the total RAPS scale, had lower weight and lower diastolic blood pressure than nonpressure ulcer patients did. In the multiple logistic regression analyses using variables included in the RAPS scale immobility emerged as a strong risk factor. When adding remaining significant variables in the analyses, mobility, time of hospitalization, age, surgical treatment and weight were found to be risk factors for pressure ulcer development.


CONCLUSIONS
It is confirmed that immobility is a risk factor of major importance for pressure ulcer development among adult hospitalized patients. The results also indicate that the RAPS scale may be useful for prediction of pressure ulcer development in clinical practice.
Department of Medicine and Care, Division of Nursing Science, Faculty of Health Sciences, Linköping University, Linköping, Sweden. margareta.lindgren@imv.liu.se
Margareta
M
Lindgren
Mitra
M
Unosson
Mats
M
Fredrikson
Anna-Christina
AC
Ek
D000203:Activities of Daily Living; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D001510:Bed Rest / Q000009:adverse effects*; D005260:Female; D006766:Hospitals, County; D006785:Hospitals, University; D006801:Humans; D007103:Immobilization / Q000009:adverse effects*; D007297:Inpatients; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009730:Nursing Assessment; D015596:Nutrition Assessment; D011237:Predictive Value of Tests; D003668:Pressure Ulcer / Q000453:epidemiology / Q000209:etiology*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013548:Sweden / Q000453:epidemiology