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Risk factors for pressure ulcers in bedridden elderly subjects: Importance of turning over in bed and serum albumin level
Author(s) -
Mino Yoshio,
Morimoto Shigeto,
Okaishi Kohya,
Sakurai Shoroku,
Onishi Miyuki,
Okuro Masashi,
Matsuo Akiko,
Ogihara Toshio
Publication year - 2001
Publication title -
geriatrics and gerontology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 57
eISSN - 1447-0594
pISSN - 1444-1586
DOI - 10.1046/j.1444-1586.2001.00008.x
Subject(s) - medicine , hypoalbuminemia , diabetes mellitus , blood pressure , logistic regression , confidence interval , risk factor , albumin , hemoglobin , serum albumin , relative risk , odds ratio , endocrinology
Background: The purpose of the present paper was to determine clinical risk factors for the development of pressure ulcers in bedridden elderly inpatients. Methods: A case‐control study was performed for 117 subjects with pressure ulcers (mean age: 80.6 ± 7.2 years) with a 1‐year observation period, and 351 age‐ and sex‐matched controls. Factors examined were subitems of the Braden scale; convenient clinical assessment (continence, sitting, turning, oral intake, and sitting up); underlying chronic conditions (stroke and diabetes mellitus); and circulating levels of albumin, total cholesterol, total lymphocyte count, and hemoglobin. Results: Compared to the controls, test cases showed lower scores of the Braden scale and lower levels of circulating factors, and higher incidences of incapability of the subitems of convenient clinical assessment, and of diabetes mellitus ( P < 0.20). Three models of multiple logistic regression analysis revealed that decreased serum level of albumin and impaired self‐positioning in bed were significant independent risk factors. The relative risk for the development of pressure ulcers after full adjustment in the group with both hypoalbuminemia (< 35 g/L) and incapability of turning over in bed, the group with the former risk alone, and the group with the latter risk alone, was 14.0 (95% confidence interval (CI): 4.2–46.6), 4.9 (1.6–14.9), and 5.9 (1.8–19.0), respectively, compared to subjects without the two risk factors. Moreover, decreased circulating levels of albumin and hemoglobin were associated with aggravation of pressure ulcers. Conclusion: A combined measure of albumin and incapability of self‐positioning may serve as a simple but useful index for the risk of pressure ulcers in bedridden elderly inpatients.