BioAcyl Corp

Purpose

This study investigates the impact of pressure ulcers (PU) on long-term survival in hospitalized older adults, to understand how frailty and PU interact to influence mortality and to explore their independent prognostic accuracy.

Methods

Between February 21, 2022, and July 1, 2022, 324 patients (198 female, 126 male; mean age: 86), admitted to the Geriatric Unit and Transitional Care of San Bartolomeo Hospital, Sarzana, Italy, were enrolled. A comprehensive geriatric assessment (CGA) was performed by geriatricians, including the assessment of frailty using the Clinical Frailty Scale (CFS), and PU assessment, carried out by a trained nurse. Long-term mortality (median duration: 18 months) was collected through the regional electronic health data system with an 18-month follow-up period.

Results

Older adults with PU had advanced frailty, higher nutritional risk, increased disability, and higher polypharmacy. Multivariate analysis showed that both frailty (CFS: HR 1.535, 95% CI 1.314–1.793, p < 0.001) and PU (HR 1.500, 95% CI 1.059–2.126, p = 0.020) were significant predictors of long-term mortality. Namely, each increment in CFS score was associated with a 53% increased risk in PU carriers. No significant interaction between CFS and PU on survival outcomes was found.

Conclusion

The study underscored the independent prognostic significance of both PU and frailty in predicting long-term mortality in hospitalized older adults. A multidimensional approach considering both frailty and PU is crucial for accurate prognostication and improving care strategies for older patients.