title: Hypotension is a risk factor for new pressure ulcer occurrence in older patients after admission to an acute hospital.
abstract: BACKGROUND
  Pressure ulcer occurrence in older patients admitted to hospital has not been studied thoroughly; yet, pressure ulcers frequently develop among the frail older patients who are hospitalized. Identifying risk factors for pressure ulcer occurrence is of utmost importance in preventing its development in this group of patients. Hypoperfusion, as manifested by hypotension, is theoretically important in the development of pressure ulcer. However, studies on this aspect are scarce.
  
  
  OBJECTIVE
  To examine whether a hypotensive episode (systolic blood pressure less than or equal to 90 mm Hg) is associated with pressure ulcer occurrence.
  
  
  METHODS
  This was a retrospective cohort study in a regional hospital. It recruited 259 patients aged 65 or older who were admitted to a convalescence ward and had a hospital stay for more than 5 days. Baseline clinical characteristics and the possible risk factors of pressure ulcer occurrence on admission and any episode of hypotension were recorded. The primary outcome measured was the incidence of pressure ulcer occurrence in the index admission.
  
  
  RESULTS
  Hypotension was strongly associated with incident pressure ulcer occurrence (odds ratio 6.71, P = .001).
  
  
  CONCLUSIONS
  Hypotension was an important risk factor for incident pressure ulcer occurrence during hospital stay. Every effort has to be taken to try to prevent hypotension. Precautions to prevent pressure ulcer development should be taken on patients who are hypotensive.
authors.affiliation: Department of Medicine and Geriatrics, Pok Oi Hospital, Hong Kong SAR. dspm2009@hotmail.com
authors.forename: Shiu-piu
authors.initials: SP
authors.lastname: Man
authors.forename: Tung-wai
authors.initials: TW
authors.lastname: Au-Yeung
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D016330:Frail Elderly; D006723:Hong Kong; D006760:Hospitalization; D006801:Humans; D007022:Hypotension / Q000453:epidemiology*; D015994:Incidence; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D003668:Pressure Ulcer / Q000453:epidemiology* / Q000517:prevention & control; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Pressure ulcer; hospitalized; hypotension; older adult; risk factor