Hypotension is a risk factor for new pressure ulcer occurrence in older patients after admission to an acute hospital

Abstract

Background: Pressure ulcer occurrence in older patients admitted to hospital has not been studied thoroughly; yet, pressure ulcers frequently develop among the frail older patients who are hospitalized. Identifying risk factors for pressure ulcer occurrence is of utmost importance in preventing its development in this group of patients. Hypoperfusion, as manifested by hypotension, is theoretically important in the development of pressure ulcer. However, studies on this aspect are scarce.

Objective: To examine whether a hypotensive episode (systolic blood pressure less than or equal to 90 mm Hg) is associated with pressure ulcer occurrence.

Method: This was a retrospective cohort study in a regional hospital. It recruited 259 patients aged 65 or older who were admitted to a convalescence ward and had a hospital stay for more than 5 days. Baseline clinical characteristics and the possible risk factors of pressure ulcer occurrence on admission and any episode of hypotension were recorded. The primary outcome measured was the incidence of pressure ulcer occurrence in the index admission.

Results: Hypotension was strongly associated with incident pressure ulcer occurrence (odds ratio 6.71, P = .001).

Conclusions: Hypotension was an important risk factor for incident pressure ulcer occurrence during hospital stay. Every effort has to be taken to try to prevent hypotension. Precautions to prevent pressure ulcer development should be taken on patients who are hypotensive.

Keywords: Pressure ulcer; hospitalized; hypotension; older adult; risk factor.