title: Malnutrition and pressure ulcer risk in adults in Australian health care facilities.
abstract: OBJECTIVE
  To determine the effect of nutritional status on the presence and severity of pressure ulcer.
  
  
  METHODS
  A multicenter, cross-sectional audit of nutritional status of a convenience sample of subjects was carried out as part of a large audit of pressure ulcers in a sample of Queensland, Australia, public healthcare facilities in 2002 and 2003. Dietitians in 20 hospitals and 6 residential aged care facilities conducted single-day nutritional status audits of 2208 acute and 839 aged care subjects using the Subjective Global Assessment. The effect of nutritional status on the presence and severity (highest stage and number of pressure ulcers) was determined by logistic regression in a model controlling for age, gender, medical specialty, and facility location. The potential clustering effect of facility was accounted for in the model using an analysis of correlated data approach.
  
  
  RESULTS
  Subjects with malnutrition had adjusted odds ratios of 2.6 (95% confidence interval 1.8-3.5, P<0.001) of having a pressure ulcer in acute care facilities and 2.0 (95% confidence interval 1.5-2.7, P<0.001) for residential aged care facilities. There was also increased odds ratio of having a pressure ulcer, and having a more severe pressure ulcer (higher stage pressure ulcer and/or a higher number) with increased severity of malnutrition.
  
  
  CONCLUSIONS
  Malnutrition was associated with at least twice the odds ratio of having a pressure ulcer of in public health care facilities in Queensland. Action must be taken to identify, prevent, and treat malnutrition, especially in patients at risk of pressure ulcer.
authors.affiliation: Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia. merrilyn_banks@health.qld.gov.au
authors.forename: Merrilyn
authors.initials: M
authors.lastname: Banks
authors.forename: Judith
authors.initials: J
authors.lastname: Bauer
authors.forename: Nicholas
authors.initials: N
authors.lastname: Graves
authors.forename: Susan
authors.initials: S
authors.lastname: Ash
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization; D006761:Hospitals; D006801:Humans; D016015:Logistic Models; D008297:Male; D044342:Malnutrition / Q000150:complications*; D008485:Medical Audit; D008875:Middle Aged; D009752:Nutritional Status; D016017:Odds Ratio; D003668:Pressure Ulcer / Q000209:etiology*; D011793:Queensland; D012307:Risk Factors; D012866:Skilled Nursing Facilities