New UCLA study reports bedsores can be fatal

Actor Christopher Reeve is a famous example of the complications of bedsores. The famous actor, who became quadriplegic after falling from his horse, succumbed to complications of a pressure ulcer, more commonly known as a bedsore. Bedridden patients not uncommonly develop bedsores. A new UCLA-led study published in the October issue of the Journal of the American Geriatrics Society has reported a direct correlation between hospital bedsores and patient mortality.

Researchers affiliated with the UCLA School of Nursing report that they believe that their study is the first of its kind to use data directly from medical records to assess the impact of hospital-acquired pressure ulcers on Medicare patients at national and state levels. The study authors note that seniors who developed pressure ulcers were more likely to die during their hospital stay, to have longer stays in the hospital, and to be readmitted to the hospital within 30 days of their discharge. They evaluated data on 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,” noted Dr. Courtney Lyder, lead investigator on the study and dean of the UCLA School of Nursing. He added, “It is incumbent upon hospitals to identify individuals at high risk for these ulcers and implement preventive interventions immediately upon admission.”

The investigators noted that individuals at the highest risk are those with existing chronic conditions, such as congestive heart failure, pulmonary disease, cardiovascular disease, diabetes and obesity, as well as patients on steroids. While conducting the study, the investigators discovered that there is no large single database to help determine the incidence of pressure ulcers among hospitalized Medicare patients. This prevented a challenge; thus, they extracted the data from Medicare’s claim history, a national surveillance system designed to identify adverse events — or “unintended harm” — within the hospitalized Medicare population. They evaluated this data to determine the cause and patterns of hospital-acquired pressure ulcers.

The researchers found that 4.5% of the patients tracked acquired a pressure ulcer during their hospital stay. The majority of these bedsores were found on the tailbone or sacrum, followed by the hip, buttocks and heels. The study also revealed that of the nearly 3,000 individuals who entered the hospital with a pressure ulcer, 16.7% developed at least one new bedsore on a different part of their body during their hospitalization. “This is a serious issue, and now we have data that can help the healthcare system address this ongoing problem,” explained Dr. Lyder. He added, “When individuals enter the hospital with the risk conditions that we’ve identified, it should send up an immediate warning signal that appropriate steps should be taken to minimize the chance of pressure ulcers occurring.”

Take home message: If a loved one is hospitalized at a facility such as Ronald Regan UCLA Medical Center, steps to reduce the risk of pressure ulcers will be taken to prevent pressure ulcers. If they occur, they will be promptly treated. However, some hospitals and nursing homes do not provide the same level of care as that provided by UCLA. Furthermore, many bedridden seniors are cared for at their home. These individuals are at significant risk of developing a pressure ulcer. If you have a loved one at risk for pressure ulcers, you must assume the role of an advocate to insure that he or she does not develop a pressure ulcer and if one develops that it is promptly treated.

A bedridden should be checked for pressure ulcers every day. A head-to-toe examination should be conducted. Pay special attention to the areas where pressure ulcers often form. Look for reddened areas that, when pressed, do not turn white. Also look for blisters, sores, or craters.

Take the following steps to prevent pressure ulcers:

• Change position at least every two hours to relieve pressure.
• Use items that can help reduce pressure: pillows, sheepskin, foam padding, and powders from medical supply stores.
• Insure that the patient is eating well-balanced meals that contain enough calories to promote health.
• Encourage the patient to drink plenty of water (8 to 10 cups) every day.
• Assist in a daily exercise program, including range-of-motion exercises.
• Keep the skin clean and dry.
• After urinating or having a bowel movement, check to see that the area is clean and dry.
• Apply physician-recommended creams to help protect the skin.

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New UCLA study reports bedsores can be fatal