The relationship between stress and pressure sore formation

The purpose of this study was to explore the relationship between serum cortisol and pressure sore formation among persons over age 65 who recently relocated to a nursing home. Twenty-six subjects who exhibited risk for pressure sore formation and were free of pressure sores and diagnoses or medications known to affect cortisol were recruited from consecutive admissions to a nursing home. Morning and evening cortisol levels were assayed the first and second weeks following admission, and subject's skin and risk status were assessed twice weekly for five weeks. Subjects who developed pressure sores had significantly higher cortisol levels than those who did not (p < 0.02), with the greatest differences occurring in the second week (p < 0.002). The cortisol levels observed in subjects who developed pressure sores may be due to the stress of relocation, but other explanations are also possible. Furthermore, a causal relationship between cortisol and pressure sore development cannot be inferred.