The impact of malnutrition and nutrition-related factors on the development and severity of pressure ulcers in older patients receiving home care.
OBJECTIVE
To investigate the impact of nutritional status and nutrition-related factors on the development and severity of pressure ulcers acquired in the home care setting.


METHODS
Two hundred and seven home care offices in Japan were selected at random and 290 patients with home-acquired pressure ulcers and 456 patients without pressure ulcers were analyzed. Data on nutritional status, caregiver knowledge, and health professional's nutritional management were collected. Pressure ulcers were categorized as superficial or full-thickness.


RESULTS
Malnutrition was significantly and most strongly associated with higher rate of the pressure ulcer after adjusting for other risk factors (OR, 2.29; 95% CI, 1.53-3.44). Assessment of the patient's nutritional status and adequate dietary intake by a health professional were significantly associated with lower odds for developing pressure ulcers (OR, 0.43, 0.47; 95% CI, 0.27-0.68, 0.28-0.79, respectively). Malnutrition was also significantly and most strongly associated with more severe pressure ulcers (OR, 1.88; 95% CI, 1.03-3.45). Assessment of a caregiver's nutritional knowledge by a health professional was a significant preventive factor for severe pressure ulcers.


CONCLUSIONS
The quality of home care for risk factors such as pressure redistribution has improved, making nutritional management a more crucial factor in pressure ulcer prevention.
Iizaka
Shinji
S
Department of Gerontological Nursing/Wound Care Management, Division of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. iizaka-tky@umin.ac.jp
Okuwa
Mayumi
M
Sugama
Junko
J
Sanada
Hiromi
H
D000369:Aged, 80 and over; D017028:Caregivers; D016022:Case-Control Studies; D015984:Causality; D002983:Clinical Competence / Q000706:statistics & numerical data; D015897:Comorbidity; D004032:Diet / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D015577:Geriatric Assessment / Q000379:methods* / Q000706:statistics & numerical data; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D044342:Malnutrition / Q000453:epidemiology*; D009747:Nutritional Physiological Phenomena; D009752:Nutritional Status; D016017:Odds Ratio; D003668:Pressure Ulcer / Q000453:epidemiology*; D012307:Risk Factors; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires