Did full-thickness pressure ulcers heal in patients who died within 180 days?

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Researchers conducted a non-experimental, retrospective analysis of pressure ulcer quality-assurance data from October 1997 to October 2002 to examine relationships between hospital-acquired full-thickness pressure ulcers, healing, and mortality. They assessed records of 74 patients (one woman and 73 men) who developed full-thickness pressure ulcers as inpatients at a regional Veterans Affairs medical center with acute, intensive, and long-term care units.

The start day was when the ulcer was determined to have occurred, and the end day was when the patient was pronounced dead. Major diagnoses among the patients were cerebrovascular accident, diabetes, and cancer; end-of-life planning was in effect for 70.7% of them. Most ulcers were located in the sacral/coccygeal area (66.2%) or heel (16.2%).

None of the ulcers healed in patients who died within 180 days of ulcer onset. The 180-day mortality rate among patients who developed hospital-acquired full-thickness pressure ulcers was 68.9%, with an average of 47.0 days from ulcer onset to death. No deaths were related to the presence of the pressure ulcer.

In this dataset of people with a heavy disease burden who were approaching the end of life, the authors considered full-thickness pressure ulcers to be an accompanying pathological process. They noted that collecting and analyzing long-term pressure ulcer healing and mortality outcomes is a missing component of pressure ulcer quality-assurance data.