Pressure ulcers: more lethal than we thought?
OBJECTIVE
To investigate the burden of pressure ulcer-associated mortality in the United States and to examine racial/ethnic differences and associated comorbidities.


METHODS
A descriptive study with matched odds ratio comparisons.


METHODS
The United States, 1990-2001.


METHODS
Pressure ulcer-associated deaths were identified from national multiple cause-coded death records from 1990 to 2001.


METHODS
Age-adjusted mortality rates and matched odds ratio comparisons of pressure ulcer-associated deaths with deaths from other conditions.


RESULTS
Between 1990 and 2001, pressure ulcers were reported as a cause of death among 114,380 persons (age-adjusted mortality rate, 3.79 per 100,000 population; 95% confidence interval [CI], 3.77-3.81). For 21,365 (18.7%) of these deaths, pressure ulcers were reported as the underlying cause. Nearly 80% of pressure ulcer-associated deaths occurred in persons at least 75 years old. Septicemia was reported in 39.7% of pressure ulcer-associated deaths (matched odds ratio, 11.3; 95% CI, 11.0-11.7). Multiple sclerosis, paralysis, Alzheimer disease, osteoporosis, and Parkinson disease were reported more often in pressure ulcer-associated deaths than in matched controls. Pressure ulcer-associated mortality was higher among blacks than among whites (age-adjusted rate ratio, 4.22; 95% CI, 4.16-4.27).


CONCLUSIONS
Pressure ulcers are associated with fatal septic infections and are reported as a cause of thousands of deaths each year in the United States. Incapacitating chronic and neurodegenerative conditions are common comorbidities, and mortality rates in blacks are higher than in other racial/ethnic groups.
Redelings
Matthew D
MD
Los Angeles County Department of Health Services, Los Angeles, CA, USA.
Lee
Nolan E
NE
Sorvillo
Frank
F
D001741:Black or African American / Q000706:statistics & numerical data; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications; D016022:Case-Control Studies; D002423:Cause of Death / Q000639:trends*; D015897:Comorbidity; D017281:Cost of Illness; D003644:Death Certificates; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D009103:Multiple Sclerosis / Q000150:complications; D016017:Odds Ratio; D010024:Osteoporosis / Q000150:complications; D010243:Paralysis / Q000150:complications; D010300:Parkinson Disease / Q000150:complications; D011159:Population Surveillance; D003668:Pressure Ulcer / Q000208:ethnology / Q000209:etiology / Q000401:mortality*; D012307:Risk Factors; D018805:Sepsis / Q000150:complications; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data