Risk factors of Pressure Ulcers in hospitalized elderly Egyptian people

Background Pressure ulcers (PUs) are increasing with aging of the population around the world and represent a common and frustrating problem affecting geriatric patients. Age-related skin changes increase the vulnerability to ulceration. Aging not only increases the risk of PU occurrence, but also affects healing of such ulcers. Also, frailty, associated comorbidities, impaired mobility, and cognitive impairment predispose many elderly populations to the development of PUs (1, 2). The prevalence of PUs peaks in those between age 70 and 80 years. They occur in hospitals, nursing homes, and even in community settings. The highest incidence of new ulcers occurs in hospitals and may be as high as 50% in acute care geriatric units, increasing health care expenditure and mortality rate, whereas the highest prevalence occurs in long-term care facilities (3). Also, the incidence of ulcers differs by the stage of ulceration. Stage 1 and 2 occur more frequently than later stages (4). Despite the progress in technology and medical advances, the cost of management of hospital acquired PU is increasing. The cost of treating these mainly preventable ulcers in the United Kingdom (UK) accounts for about 4% of the total National Health Service (NHS) expenditure (5). Therefore, the identification of people at risk for PUs is an important component of preventive care for the elderly (6). The National Pressure Ulcer Advisory Panel (NPUAP) has agreed that not all PUs are preventable and there are clinical situations in which the development of PUs can be unavoidable such as end stage dementia, severe congestive heart failure and forced immobilization (7). To our knowledge only few studies were done in Egypt, approaching mainly nurses’ knowledge and educational programs about PU and no studies searched for risk factors for PU in Egyptian population (8, 9, 10).