title: Pressure sores following elective total hip arthroplasty: pitfalls of misinterpretation.
abstract: OBJECTIVE
  To assess the reliability of reporting protocols regarding pressure sores.
  
  
  METHODS
  Retrospective data were collected regarding pressure sore rates following total hip arthroplasty operations carried out during 2001 at two orthopaedic units in an NHS hospital (Princess Royal Hospital) and in a local private hospital.
  
  
  RESULTS
  Preliminary results presented in audit and interim reports indicated an alarmingly high pressure sore rate across the two sites (17/172 [9.9%] NHS, 23/71 [32.4%] private hospital). On analysis, the data collection system was revealed to be flawed. Grade 1 areas (erythema with no ulceration) were included, leading to a dramatic discrepancy between reported and confirmed pressure sores. Re-analysis showed the confirmed pressure sore rates to be much lower (2.3% NHS, 1.0% private hospital).
  
  
  CONCLUSIONS
  This audit suggests that both poor data collection and education lead to inaccurate audit. This may lead to subsequent inappropriate management and inappropriate NHS star ratings.
authors.affiliation: Department of Orthopaedic Surgery, Princess Royal Hospital, Haywards Heath, West Sussex, UK.
authors.forename: Nicole
authors.initials: N
authors.lastname: Keong
authors.forename: David
authors.initials: D
authors.lastname: Ricketts
authors.forename: Nuki
authors.initials: N
authors.lastname: Alakeson
authors.forename: Philippa
authors.initials: P
authors.lastname: Rust
mesh_terms: D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D017558:Elective Surgical Procedures; D004739:England / Q000453:epidemiology; D006620:Hip Fractures / Q000601:surgery*; D006801:Humans; D015994:Incidence; D003668:Pressure Ulcer / Q000453:epidemiology / Q000209:etiology*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors