Document Detail


Predictors of pressure ulcer healing among long-term care residents.
MedLine Citation:
PMID:  8994484     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To identify predictors of pressure ulcer healing among long-term care residents. DESIGN: A retrospective cohort study. SETTING: Department of Veterans Affairs (VA) long-term care facilities. PARTICIPANTS: All long-term care residents with a pressure ulcer on April 1, 1993, who remained institutionalized as of October 1, 1993. Patients and pressure ulcer status were identified from the Patient Assessment File, a VA administrative database. MEASUREMENTS: Pressure ulcers were considered healed if patients were without an ulcer on October 1, 1993. Predictors of pressure ulcer healing were selected from among patient characteristics in the Patient Assessment File. RESULTS: Pressure ulcers were present in 7.7% of the long-term care residents institutionalized as of April 1, 1993. Among the 819 pressure ulcer patients remaining institutionalized as of October 1, 1993, ulcers had healed in 442 (54.0%). Seventy-two percent of patients with Stage 2 ulcers were ulcer-free at 6 months, compared with 45.2% of patients with Stage 3 ulcers and 30.6% of those with Stage 4 ulcers (P < .001). Significant (P < .05) independent predictors of healing included pressure ulcer size (Odds ratio (OR) = 5.2 for Stage 2 ulcers, OR = 1.5 for Stage 3 ulcers), older age (OR = 1.5), and receiving rehabilitation services (OR = 1.3 for each additional type of therapy). Both immobility (OR = .3) and incontinence (OR = .7) were associated with ulcers not healing. CONCLUSIONS: Most Stage 2 pressure ulcers, and many larger ulcers encountered in long-term care settings will heal. Baseline patient characteristics are important predictors of healing. Interventions may then be targeted at patients whose ulcers are unlikely to heal, and observed facility performance may be compared with expected outcomes.
Authors:
D R Berlowitz; G H Brandeis; J Anderson; H K Brand
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of the American Geriatrics Society     Volume:  45     ISSN:  0002-8614     ISO Abbreviation:  J Am Geriatr Soc     Publication Date:  1997 Jan 
Date Detail:
Created Date:  1997-02-04     Completed Date:  1997-02-04     Revised Date:  2008-03-10    
Medline Journal Info:
Nlm Unique ID:  7503062     Medline TA:  J Am Geriatr Soc     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  30-4     Citation Subset:  IM    
Affiliation:
Bedford VA Hospital, Massachusetts, USA.
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living
Aged
Cohort Studies
Female
Humans
Logistic Models
Long-Term Care*
Male
Predictive Value of Tests
Pressure Ulcer / classification*
Retrospective Studies
Wound Healing*
Grant Support
ID/Acronym/Agency:
AG00499/AG/NIA NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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