title: Six-month mortality risks in long-term care residents with chronic ulcers.
abstract: Chronic ulcers are a common problem in long-term care. Residents with ongoing ulcers are often frail and at risk for mortality. This study evaluated the relationship between wound characteristics and other health predictors with 6-month mortality in nursing home residents. The subjects included were nursing home residents seen by the wound consult service from 1998 to 2007 with an ongoing chronic ulcer. This was a retrospective cohort study. Data were manually and electronically abstracted for each resident. Six-month mortality was collected as the primary outcome. Statistical comparisons were made using logistic regression with a final multivariant model. Four hundred and forty residents were seen with 411 records reviewed. Ulcer area was not associated with mortality; however, chronic ulcer number was associated with 6-month mortality with an odds ratio of 1.32 (95% CI 1.07-1.63). Other significant risk factors included heart failure, dementia, cancer, depression and blindness with all factors having an odds ratio greater than 1.75. Higher haemoglobin and venous insufficiency were protective of 6-month mortality. Ulcer number is an important predictor for 6-month mortality. The presence of multiple ulcers and comorbid health concerns may influence discussion of prognosis for healing and for potential end of life discussions.
authors.affiliation: Kogod Program on Aging, Department of Internal Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA. takahashi.paul@mayo.edu
authors.forename: Paul Y
authors.initials: PY
authors.lastname: Takahashi
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Cha
authors.forename: Lester J
authors.initials: LJ
authors.lastname: Kiemele
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment; D006801:Humans; D016015:Logistic Models; D008134:Long-Term Care; D008297:Male; D008910:Minnesota / Q000453:epidemiology; D015999:Multivariate Analysis; D009735:Nursing Homes; D011237:Predictive Value of Tests; D003668:Pressure Ulcer / Q000097:blood / Q000150:complications / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012883:Skin Ulcer / Q000097:blood / Q000150:complications / Q000401:mortality*