Study Spearheaded by UCLA Nursing School Dean Finds Direct Correlation Between Bed Sores and Patient Mortality

<0> UCLA School of NursingLaura Perry310-794-4022 </0>

A new clinical study spearheaded by the dean of the UCLA School of Nursing has found a direct correlation between pressure ulcers – commonly known as “bed sores” – and patient mortality and increased hospitalization. This is believed to be the first study of its kind to use data directly from medical records to assess hospital-acquired pressure ulcers in Medicare patients at the national and state levels.

According to the study, the lead article in the September issue of the , individuals who developed pressure ulcers were more likely to die during their hospital stay, have generally longer hospital lengths of stay, and have a greater likelihood of being readmitted within 30 days of discharge. To arrive at its findings, the study tracked more than 51,000 randomly selected Medicare beneficiaries hospitalized across the United States in 2006 and 2007.

“Hospital-acquired pressure ulcers were shown to be an important risk factor associated with mortality,” said Courtney Lyder, ND, ScD(Hon), FAAN, lead investigator and dean. “It is incumbent upon hospitals to identify individuals at high risk for these ulcers and implement preventive interventions immediately upon admission.” According to Dr. Lyder and his research team, individuals at the highest risk are those with existing chronic conditions such as congestive heart failure, pulmonary disease, cardiovascular disease, diabetes, obesity and those on steroids.

In conducting the study researchers were challenged by the fact that there is no large single database to help determine incidence of pressure ulcers among hospitalized Medicare patients. Data for the study therefore came from Medicare’s claim history, a national surveillance system designed to identify adverse events – or “unintended harm” – within the hospitalized Medicare population. Researchers looked at data from this source to determine the cause and patterns for hospital-acquired pressure ulcers.

The study found that 4.5 percent of the patients tracked acquired a hospital-acquired pressure ulcer during their stay. The majority of these bed sores were found on the tailbone or sacrum, followed by the hip, buttock and heels. The study also revealed that of the nearly 3,000 individuals who entered the hospital with a pressure ulcer, 16.7 percent developed at least one new bed sore on a different part of their body during hospitalization.

“This is a serious issue, and now we have data that can help the healthcare system address this ongoing problem,” said Dr. Lyder. “Individuals entering the hospital with the risk conditions that we’ve identified should send up an immediate warning signal that appropriate steps should be taken to minimize the chance of pressure ulcers occurring.”

In addition to Dr. Lyder, clinical researchers in this study included Yun Wang, Ph.D., Qualidigm, Centers for Outcomes Research and Evaluation, Yale University and Yale-New Haven Health; Mark Metersky, M.D., Qualidigm and the Division of Pulmonary and Critical Care Medicine, School of Medicine, University of Connecticut; Maureen Curry, MHA, Qualidigm; Rebecca Kliman, MPH, Office of Clinical Standards and Quality, Centers for Medicare and Medicaid Services; Nancy Verzier, MSN, Qualidigm; and David Hunt, M.D., Office of Health Information Technology Adoption, Office of the National Coordinator for Health IT.

The study was funded by the Centers for Medicare and Medicaid Services.

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