Trends in mortality due to pressure ulcers in Spain, over the period 1999-2016

Abstract

Aim: to analyse trends in mortality by Pressure Ulcers (PU) in Spain, between 1999 and 2016.

Methods: Mortality due to PU in residents in Spain over 65, where a PU was underlying/basic cause of death, was analysed. Data for populations and deaths were gathered from the Spanish National Statistics Institute. Variables were age, sex, year of death and underlying/basic cause of death. Age-adjusted mortality rates were calculated (direct method), with 2013 European standard population. To analyse temporal trends and to detect significant changes, joinpoint regression models were adjusted to estimate average annual percentage change of Age-Adjusted mortality Rates for each segment detected. An analysis was performed for those over 65, and by the age groups 65-84, and over 84 years.

Results: A total of 11,238 deaths due to PU in people over 65, between 1999 and 2016, were analysed. There was a general decrease for both, women and men, over the period. From the Joinpoint analysis, for men, two changes were detected in those over 65, with a significant decrease observed until 2008. For those over 84, was a significant decrease of 4.4% on average per year. For women, a significant decrease is observed in all age groups, with a change of trend in 2007.

Conclusion: This study provides a general overview of the epidemiology of PU mortality in Spain. It may serve as a confirmation of the good health policies carried out in the past on PU, given that we observe a generalised decrease in mortality from PUs over the period. Mortality was higher in women at the beginning of the period but without differences at the end, compared with men. Changes occurred over time could be explained by implementation of patient safety policies.

Keywords: Adverse effects; Mortality; Patient safety; Population-based methods; Pressure ulcers.