Pressure Ulcers and Malnutrition: Results from a Snapshot Sampling in a University Hospital

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, χ² 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.

Incidence of pressure injury in an oncological intensive care unit

“…In this way, the patient can be provided with the necessary calories, proteins, amino acids, vitamins and water, maintaining an adequate nutritional status (22) . A longitudinal study conducted among 471 hospitalized adults identified a higher incidence of PI among those who received enteral nutrition, and also among patients with malnutrition (23) . The causal relationship between nutritional status and PI is yet to be fully clarified (23) .…”

Nutritional management of older hospitalised patients with pressure injuries

“…Pressure injuries represent a serious and complex health problem in older persons . As a result of geriatric syndromes such as incontinence, reduced mobility, or malnutrition, older persons in hospitals are at increased risk of developing a pressure injury .…”

“…1 Pressure injuries represent a serious and complex health problem in older persons. [2][3][4] As a result of geriatric syndromes such as incontinence, reduced mobility, or malnutrition, older persons in hospitals are at increased risk of developing a pressure injury. 2 The prevalence of pressure injuries in the acute care setting is between 6% and 18.5%, depending on the underlying methodology used to measure these rates.…”

Nutritional Screening and Clinical Outcome in Hospitalized Patients with Crohn’s Disease

“…Conversely, Tevik et al [18] found that the incidence of complications and the median LOS were significantly higher in patients with NRS 2002 scores ≥3, concluding that the NRS 2002 was a reliable screening tool in their sample of hospitalized patients with chronic heart failure. Moreover, multivariate analysis conducted by Tsaousi et al [22] highlighted limited autonomy in everyday activities, MUST score, and artificial nutrition as the most powerful predictors of pressure ulcers. Lomivorotov et al [23] reported the prognostic value of different nutritional screening tools – SGA, NRS 2002, MUST, Mini-Nutritional Assessment, and Short Nutritional Assessment Questionnaire – in patients undergoing cardiopulmonary bypass.…”