Pressure ulcers and malnutrition: results from a snapshot sampling in a university hospital

Med Princ Pract. 2015;24(1):11-6. doi: 10.1159/000368360. Epub 2014 Nov 7.

Abstract

Objective: We aimed to ascertain the factors potentially contributing to the manifestation of pressure ulcers (PU) due to poor nutritional status in a nonselected hospitalized population.

Subjects and methods: This is a prospective cohort study of 471 adult inpatients treated at our university hospital. Study parameters included anthropometric data, demographics, medical history, mood status, diet-related factors and self-perception of health status. For each participant, the body mass index (BMI) was calculated, and a malnutrition universal screening tool (MUST) was used to screen for nutritional deficiencies, with the presence of PU constituting the outcome of interest. An independent-samples t test, χ(2) analysis and logistic regression analysis were performed.

Results: The overall prevalence of PU in our cohort was 14.2%. Advanced age, low BMI, poor health status by self-assessment, serious mood disorders, malnutrition, abnormal appetite status, a quantity of food intake half of normal, an artificial diet, limited or no autonomy in everyday activities (p < 0.01 for all) and recent weight loss (p < 0.05) were identified as important determinants for the manifestation of PU. Multivariate analysis highlighted limited autonomy in everyday activities (OR 6.456 and 95% CI 3.212-12.973; p = 0.000), MUST score (OR 3.825 and 95% CI 1.730-8.455; p = 0.001) and artificial diet (OR 1.869 and 95% CI 1.247-2.802; p = 0.018) as the most powerful predictors of PU development.

Conclusion: Poor nutritional status, limited autonomy in everyday activities and artificial nutrition seemed to confer noteworthy prognostic value regarding PU development in the acute-care setting.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anthropometry
  • Body Mass Index
  • Comorbidity
  • Diet
  • Female
  • Hospitals, University
  • Humans
  • Interviews as Topic
  • Logistic Models
  • Male
  • Malnutrition / complications*
  • Middle Aged
  • Pressure Ulcer / complications
  • Pressure Ulcer / epidemiology*
  • Prospective Studies
  • Risk Factors