Factors Affecting Pressure Sores in Palliative Care Patients

INTRODUCTION: Determining the risks in terms of preventing the formation of pressure sores and the progression of existing wounds is very important in reducing mortality. In our study, we aimed to determine the factors affecting the formation of pressure ulcers and the stage of the wound in patients hospitalized in a palliative care center.
METHODS: The material of our cross-sectional and retrospective study consisted of patients hospitalized in a palliative care center between January 2017 and February 2018. The age, gender, primary diagnosis, comorbidities, hemoglobin, hematocrit, lymphocyte, neutrophil, C-reactive protein, albumin, and prealbumin values, and NRS 2002 scores of the patients were recorded; and the relationship of these variables with pressure ulcer information was analyzed.
RESULTS: Of the patients participating in our study, 277 (55.1%) were female, and 226 (44.9%) were male. According to the results of our study, the risk of pressure ulcers increases in patients over 65 years of age and in female patients. Having a cerebrovascular accident or dementia/Alzheimer's disease increases the risk of advanced wounds. The presence of hypertension or cardiovascular disease increases the risk of pressure ulcers. Diabetes and chronic kidney disease have not been found to be associated with wounds. Low albumin, hemoglobin, and hematocrit, and high lymphocyte levels are associated with advanced wounds. There was no statistically significant relationship between prealbumin, CRP, neutrophil levels, and the neutrophil/lymphocyte ratio and pressure ulcers.
DISCUSSION AND CONCLUSION: There is a strong relationship between the formation and progression of pressure ulcers and the diagnosis, nutritional status, presence of anemia, and hypertension. Taking precautions by being aware of the risks in elderly patients with chronic diseases and in need of care is of great importance in terms of preventing pressure ulcers, which increase morbidity and mortality.