title: Burden and outcomes of pressure ulcers in cancer patients receiving the kerala model of home based palliative care in India: results from a prospective observational study.
abstract: OBJECTIVE
  To report the prevalence and outcomes of pressure ulcers (PU) seen in a cohort of cancer patients requiring home-based palliative care.
  
  
  METHODS
  All patients referred for home care were eligible for this prospective observational study, provided they were living within a distance of 35 km from the institute and gave informed consent. During each visit, caregivers were trained and educated for providing nursing care for the patient. Dressing material for PU care was provided to all patients free of cost and care methods were demonstrated. Factors influencing the occurrence and healing of PUs were analyzed using logistic regression. Duration for healing of PU was calculated using the Kaplan Meier method. P < 0.05 are taken as significant.
  
  
  RESULTS
  Twenty-one of 108 (19.4%) enrolled patients had PU at the start of homecare services. None of the patients developed new PU during the course of home care. Complete healing of PU was seen in 9 (42.9%) patients. The median duration for healing of PU was found to be 56 days. Median expenditure incurred in patients with PU was Rs. 2323.40 with a median daily expenditure of Rs. 77.56.
  
  
  CONCLUSIONS
  The present model of homecare service delivery was found to be effective in the prevention and management of PUs. The high prevalence of PU in this cohort indicates a need for greater awareness for this complication.
  
  
  BACKGROUND
  CTRI/2014/03/004477.
authors.affiliation: Department of Palliative Medicine, Malabar Cancer Center, Moozhikkara, Kodiyeri, Thalassery, Kannur, Kerala, India.
authors.forename: Biji M
authors.initials: BM
authors.lastname: Sankaran
authors.affiliation: Department of Radiation Oncology, Malabar Cancer Center, Moozhikkara, Kodiyeri, Thalassery, Kannur, Kerala, India.
authors.forename: Santam
authors.initials: S
authors.lastname: Chakraborty
authors.affiliation: Department of Clinical Hematology, and Medical Oncology, Malabar Cancer Center, Moozhikkara, Kodiyeri, Thalassery, Kannur, Kerala, India.
authors.forename: Vijay M
authors.initials: VM
authors.lastname: Patil
authors.affiliation: Department of Palliative Medicine, Malabar Cancer Center, Moozhikkara, Kodiyeri, Thalassery, Kannur, Kerala, India.
authors.forename: Sindhu N
authors.initials: SN
authors.lastname: Raghavan
authors.affiliation: Department of Palliative Medicine, Malabar Cancer Center, Moozhikkara, Kodiyeri, Thalassery, Kannur, Kerala, India.
authors.forename: Shibimol
authors.initials: S
authors.lastname: Thomas
authors.affiliation: Department of Cancer Research and Biostatistics, Malabar Cancer Center, Moozhikkara, Kodiyeri, Thalassery, Kannur, Kerala, India.
authors.forename: Subhradev
authors.initials: S
authors.lastname: Sen
keywords: Bed sore; Cancer; Decubitus ulcer; Home care; Palliative care; Pressure ulcer