title: Incidence of hospital-acquired pressure ulcers - a population-based cohort study.
abstract: Our study sought to estimate the association between race, gender, comorbidity and body mass index (BMI) on the incidence of hospital-acquired pressure ulcer (PU) from a population-based retrospective cohort comprising 242 745 unique patient hospital discharges in two fiscal years from July 2009 to June 2010 from 15 general and tertiary care hospitals. Cases were patients with a single inpatient encounter that led to an incident PU. Controls were patients without a PU at any encounter during the two fiscal years with the earliest admission retained for analysis. Logistic regression models quantified the association of potential risk factors for PU incidence. Spline functions captured the non-linear effects of age and comorbidity. Overall 2·68% of patients experienced an incident PU during their inpatient stay. Unadjusted analyses revealed statistically significant associations by age, gender, race, comorbidity, BMI, admitted for a surgical procedure, source of admission and fiscal year, but differences by gender and race did not persist in adjusted analyses. Interactions between age, comorbidity and BMI contributed significantly to the likelihood of PU incidence. Patients who were older, with multiple comorbidities and admitted for a surgical diagnosis-related groups (DRG) were at greater risk of experiencing a PU during their stay.
authors.affiliation: Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA. jgardiner@epi.msu.edu.
authors.forename: Joseph C
authors.identifier: http://orcid.org/0000-0003-2605-6478
authors.initials: JC
authors.lastname: Gardiner
authors.affiliation: Clinical and Translational Sciences Institute, Michigan State University, East Lansing, MI, USA.|Biomedical Research Informatics Core, Michigan State University, East Lansing, MI, USA.
authors.forename: Philip L
authors.initials: PL
authors.lastname: Reed
authors.affiliation: Information Technology Services/Data Governance and Research, CHE/Trinity Health, Livonia, MI, USA.
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Bonner
authors.affiliation: Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI, USA.
authors.forename: Diana K
authors.initials: DK
authors.lastname: Haggerty
authors.affiliation: Information Technology Services/Data Governance and Research, CHE/Trinity Health, Livonia, MI, USA.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Hale
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006769:Hospitals, General / Q000706:statistics & numerical data*; D006801:Humans; D007049:Iatrogenic Disease / Q000453:epidemiology*; D015994:Incidence; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D003668:Pressure Ulcer / Q000453:epidemiology*; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D062606:Tertiary Care Centers / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology
keywords: Electronic health record; Epidemiology; Hospital-acquired pressure ulcer