Clinical Features of Pressure Ulcers in the Hospital Outpatient Department Setting

Objective

The objective of this study was to report on the patient demographics and clinical characteristics of pressure ulcers (PU) seen in hospital outpatient department wound care centers.

Methods:

Retrospective, de-identified electronic medical records for PU were extracted from the Intellicure Limited Data Set (I-LDS) from 2005-2015. The I-LDS extracts records from 110 hospital-based outpatient wound care centers. PU were identified using International Classification of Disease, 9th Revision, Clinical Modification (ICD-9 CM) diagnosis codes. Patient and PU characteristics were reported from the initial encounter in the I-LDS.

Results:

A total of 19,625 PU patients along with 36,444 initial PU assessments were identified. Patient gender was balanced at 50% male to female, Patient race was predominately white at 72% followed by black at 13%. The average patient age was 67 years (SD=19). Medicare was listed as the primary insurance at 60% followed by Commercial insurance at 24%. A majority of the patients (65%) presented with > 1 PU on the initial visit. Stage III was the most frequent PU grade reported at 31% followed by Stage II at 29%, Unstageable at 19% and Stage IV at 17%. The PU infection rate was reported at 33%. Twenty-nine percent of PU were debrided on the initial visit. The most frequent exudate volume reported was Minimum at 39% followed by Moderate at 26%. The average PU age upon initial visit was 5.5 months (SD=20) with a median age of 1.1 month and an interquartile range of 0.5 to 3.2 months. The average wound surface area was calculated at 12.8cm2 (SD=43) with a median of 2.7cm2 and an interquartile range of 0.6 to 10.2cm2.

Conclusions:

Patients presenting with PUs in hospital outpatient department wound care centers exhibited a high degree of PU severity as evident by the age, frequency and clinical stage of their wounds.