Epidemiology

Accurate assessments of pressure ulcer incidence and prevalence are difficult to obtain. Studies differ considerably in their methodology.

A literature review conducted by the National Pressure Ulcer Advisory Panel reported substantial variations in pressure ulcer incidence rates for the period 1990 to 2000 (0.4% to 38.0% among patients receiving general acute care, 2.2% to 23.9% in long term care, and 0% to 17% for home care).[2] A subsequent systematic review and meta-analysis of observational studies reported a pooled estimate incidence rate for pressure ulcer of 12% (95% CI: 10-14) across all hospital departments; the highest incidence was observed among inpatients on orthopaedic surgery wards (18.5%; 95% CI: 11.5-25.0).[3]

The incidence and prevalence of pressure ulcer increases with increasing age.[4][5] Up to two-thirds of ulcers occur on patients >70 years of age.[6] Among elderly patients being seen by a general practitioner in the UK, an overall incidence rate of 0.58 ulcers per 100 person-years was noted; rates were considerably higher in people over age 85.[4]

In the US, between 2006 and 2015, the overall prevalence of pressure ulcer in all care settings declined from 13.5% to 9.3%.[7] Long-term acute care had the highest overall prevalence of 32.9% and 28.8% in 2006 and 2015, respectively. Overall prevalence in acute care was 13.3% in 2006, reduced to between 8.8% to 9.3% during the period 2012-2015.[7]

A European study involving nearly 6000 patients in 5 countries reported that about 18% of patients admitted to the hospital had a pressure ulcer.[8] The prevalence of pressure ulcers in children admitted to the hospital varies from 0.47% to 13.10%.[9]

Prevalence rates in patients with spinal injury are 20% to 30%, 1 to 5 years after injury. One survey reported that 23% of spinal injury patients in the community had pressure damage.[10]

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