Related Experiment Video
Updated: Nov 25, 2025
An Educational Video Demonstration of How to Prone a Critically Ill Intubated Patient
Published on: November 30, 2022
Stage-related implications of community-acquired pressure injuries for the acute medical inpatients
Gianfranco Sanson1, Ilaria Barbin1, Daniela De Matteis2
1School of Nursing, Clinical Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
Aims:
To analyse the prevalence of any-stage pressure injuries at hospital admission and their impact on short-, mid- and late-term mortality. Patient characteristics associated with pressure injuries and the impact on hospital costs were also investigated.
Background:
In medical patients acutely admitted to hospital, no study analysed the presence of pre-existing pressure injuries and the related short- and long-term mortality according to the overall stages of severity thereof.
Design:
Retrospective cohort study following the STROBE guideline.
Methods:
In a population of 7217 acute medical inpatients, the presence and staging of pressure injuries were assessed at hospital admission. The impact of pressure injury on 30-, 180- and 365-day mortality was analysed by multivariate Cox regression models.
Results:
The prevalence of community-acquired pressure injuries was 14.9% (stage-1: 8.1%; stage-2: 3.5%; stage-3: 1.6%; stage-4: 1.1%; unstageable: 0.5%). Hemiplegia/paraplegia, anaemia, poor functional status, high nutritional risk, clinical instability and systemic inflammatory response, but not hydration status, were found to be associated with the occurrence of stage-2-and-above pressure injuries. An increasing difference was found in Diagnosis-Related Groups (DRG) weight according to pressure injury stages. A distinct and progressively increasing risk-of-death for any-stage pressure injury was shown after 365-days. A significantly increased mortality risk for all considered time intervals was found for unstageable and stage-4 pressure injuries.
Conclusions:
In acute medical inpatients, the presence of community-acquired pressure injuries is part of a multidimensional clinical complexity. The presence and staging of pressure injuries have an independent dramatic impact on of early-to-late mortality and hospital costs.
Relevance To Clinical Practice:
This study documented as community-acquired pressure injuries are highly prevalent and represents an independent predictor of outcomes in strict dependence of the progression of thereof stage. The presence of community-acquired pressure injuries should be interpreted as a critical marker of frailty and increased vulnerability.
Related Concept Videos
01:30Pneumonia I: Introduction
Risk Factors
Various factors influence the likelihood of developing pneumonia. Age plays a crucial role, with infants, children under two, and individuals over 65 at increased risk due to their...
01:22Acute Kidney Injury VI: Nursing Management
01:23Peripheral Artery Disease V: Postoperative Nursing Management
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
01:22Burn Injuries
The damage results in the death of skin cells, which can lead to a massive loss of fluid. Dehydration, electrolyte imbalance, and renal and circulatory failure follow, which can be fatal. Burn patients are treated with intravenous fluids to offset...