Hostname: page-component-8448b6f56d-qsmjn Total loading time: 0 Render date: 2024-04-16T18:09:07.250Z Has data issue: false hasContentIssue false

Effect of Pressure Ulcers on Length of Hospital Stay

Published online by Cambridge University Press:  21 June 2016

Nicholas Graves*
Affiliation:
School of Public Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
Frances Birrell
Affiliation:
Centre for Health Care Related Infection Surveillance and Prevention, Princess Alexandra Hospital, Wooloongabba, Queensland, Australia
Michael Whitby
Affiliation:
Centre for Health Care Related Infection Surveillance and Prevention, Princess Alexandra Hospital, Wooloongabba, Queensland, Australia
*
School of Public Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove QLD, 4059, Australian.graves@qut.edu.au

Abstract

Objective:

To identify the independent effect of pressure ulcers on excess length of stay and control for all observable factors that may also contribute to excess length of stay. Hospitalized patients who develop a pressure ulcer during their hospital stay are at a greater risk for increased length of stay as compared with patients who do not.

Design:

Cross-sectional, observational study.

Setting:

Tertiary-care referral and teaching hospital in Australia.

Patients:

Two thousand hospitalized patients 18 years and older who had a minimum stay in the hospital of 1 night and admission to selected clinical units.

Methods:

Two thousand participants were randomly selected from 4,500 patients enrolled in a prospective survey conducted between October 2002 and January 2003. Quantile median robust regression was used to assess risk factors for excess length of hospital stay.

Results:

Having a pressure ulcer resulted in a median excess length of stay of 4.31 days. Twenty other variables were statistically significant at the 5% level in the final model.

Conclusions:

Pressure ulcers make a significant independent contribution to excess length of hospitalization beyond what might be expected based on admission diagnosis. However, our estimates were substantially lower than those currently used to make predictions of the economic costs of pressure ulcers; existing estimates may overstate the true economic cost.

Type
Original Articles
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2005

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Allman, RM, Goode, PS, Burst, N, Bartolucci, AA, Thomas, DR. Pressure ulcers, hospital complications, and disease severity: impact on hospital costs and length of stay. Advances in Wound Care 1999;12:2230.Google ScholarPubMed
2.Allman, RM. Pressure sores among hospitalized patients. Ann Intern Med 1986;105:337342.CrossRefGoogle ScholarPubMed
3.Lapsley, HM, Vogels, R. Cost and prevention of pressure ulcers in an acute teaching hospital. Int J Qual Health Care 1996;8:6166.CrossRefGoogle Scholar
4.Young, J, Morey, P, Browne, R, Nikoletti, S. A study of the incidence of pressure ulcers in the acute orthopaedic setting. Primary Intention 2000;8:142147.Google Scholar
5.Miller, H, Delozier, J. Cost Implications of the Pressure Ulcer Treatment Guideline, ed. Agency for Health Care Policy and Research. Rockville, MD: Center for Health Policy Studies; 1994.Google Scholar
6.Thompson, JS, Brooks, RG. The economics of preventing and treating pressure ulcers: a pilot study. Journal of Wound Care 1999;8:312316.CrossRefGoogle Scholar
7.Petersen, NC, Bittman, S. The epidemiology of pressure sores. Scand J Plast Recensir Surg 1971;5:6266.Google ScholarPubMed
8.Gerson, LW. The incidence of pressure sores in active treatment hospitals. Int J Nurs Stud 1975;12:201204.CrossRefGoogle ScholarPubMed
9.Clark, M, Benbow, M, Butcher, M, Gebhardt, K, Teasley, G, Zoller, J. Collecting pressure ulcer prevention and management outcomes: 1. British Journal of Nursing 2002;11:230238.CrossRefGoogle ScholarPubMed
10.Clough, NP. The cost of pressure area management in an intensive care unit. Journal of Wound Care 1994;3:3335.CrossRefGoogle Scholar
11.Oot-Giromini, B. Pressure ulcer prevention versus treatment, comparative product cost study. Decubitus 1989:2:5254.Google ScholarPubMed
12.Charlier, C. Prevalence, incidence and risk: a study of pressure ulcers at a rural base hospital. Primary Intention 2001;9:1221.Google Scholar
13.Gosnell, D. Pressure ulcer incidence and severity in a community hospital. Decubitus 1992;5:5658.Google Scholar
14.Phillips, L. Cost-effective strategy for managing pressure ulcers in critical care: a prospective, non-randomised, cohort study. Supplement to Journal of Tissue Viability 2000;10:26.CrossRefGoogle ScholarPubMed
15.Bergstrom, N, Bennett, MA, Carlson, CE, et al.Treatment of Pressure Ulcers: Clinical Practice Guideline, no. 15. Rockville, MD: Agency for Health Care Policy and Research; 1994. AHCPR Publication No. 95-0652.Google Scholar
16.Goodridge, DM, Sloan, JA, LeDoyen, YM, McKenzie, JA, Knight, WE, Gayari, M. Risk-assessment scores, prevention strategies, and the incidence of pressure ulcers among the elderly in four Canadian healthcare facilities. Canadian Journal of Nursing Research 1998;30:2344.Google Scholar
17. Anonymous. What price pressure sores. Journal of Wound Care 1993; 2:191.CrossRefGoogle Scholar
18.Kuhn, BA. Balancing the pressure ulcer cost and quality equation. Nursing Economics 1992;10:353359.Google ScholarPubMed
19.National Pressure Ulcer Advisory Panel. Pressure ulcers: incidence, economics, risk assessment. Consensus development conference statement. Decubitus 1989;2:2428.Google Scholar
20. AIHW National Hospital Morbidity Database [database online]. Canberra, Australia: Australian Institute of Health and Welfare; 2003.Google Scholar
21.Australian Wound Management Association. Clinical Practice Guidelines for the Prediction and Prevention of Pressure Ulcers. West Leederville, Perth, Australia: Cambridge Publishing; 2001.Google Scholar