Assessment of Risk Factors Associated With Hospital-Acquired Pressure Injuries and Impact on Health Care Utilization and Cost Outcomes in US Hospitals

Document Type

Article

Publication Date

7-1-2018

Publication Title

American journal of medical quality

Abstract

Hospital-acquired pressure injuries (HAPI) are a societal burden and considered potentially preventable. Data on risk factors and HAPI burden are important for effective prevention initiatives. This study of the 2009-2014 US Premier Healthcare Database identified HAPI risk factors and compared outcomes after matching HAPI to non-HAPI patients. The cumulative incidence of HAPI was 0.28% (47 365 HAPI among 16 967 687 total adult inpatients). Among the matched sample of 110 808 patients (27 702 HAPI), the strongest risk factors for HAPI were prior PI (odds ratio [OR] = 12.52, 95% confidence interval [CI] = 11.93-13.15), prior diabetic foot ulcer (OR = 3.43, 95% CI = 3.20-3.68), and malnutrition (OR = 3.11, 95% CI = 3.02-3.20). HAPI patients had longer adjusted length of stay (3.7 days, P < .0001), higher total hospitalization cost ($8014, P < .0001), and greater odds of readmissions through 180 days (OR = 1.60, 95% CI = 1.55-1.65). This study demonstrates how big data may help quantify HAPI burden and improve internal hospital processes by identifying high-risk patients and informing best practices for prevention.

Medical Subject Headings

Adult; Age Factors; Aged; Aged, 80 and over; Comorbidity; Continental Population Groups; Diabetic Foot; Female; Health Services; Hospital Charges; Humans; Iatrogenic Disease; Incidence; Length of Stay; Male; Malnutrition; Middle Aged; Patient Readmission; Pressure Ulcer; Quality Indicators, Health Care; Retrospective Studies; Risk Assessment; Risk Factors; Severity of Illness Index; Sex Factors; Socioeconomic Factors

PubMed ID

29262690

Volume

33

Issue

4

First Page

348

Last Page

358

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