Incidence and Risk Factors of Pressure Ulcers in a Tunisian University Hospital

Abstract

Background: Pressure ulcers are a major problem both in our context than in studies conducted around the world. In Tunisia, few studies have focused on estimating their extent. Aim: To estimate the incidence of pressure ulcers in some at-risk departments of the Hospital of Sahloul and to identify the associated risk factors. Methods: We carried out a longitudinal study in the departments of Anesthesia-Resuscitation, Internal Medicine, and Aesthetic and Restorative Surgery at the Hospital of Sahloul during 3 months from October the 1st until December 31st, 2015. Results: Overall, 150 patients were eligible. Their mean age was 46.1 ± 20.2 years. The sex ratio was 1.94. In our study, 29 patients had pressure ulcers, which represented a patient incidence of 19.3% (95% CI: [13-25.3]). In addition, 56 episodes of pressure ulcers were observed in these patients, resulting in a pressure ulcer incidence of 37% (95% CI: [29.3-44.7]) and incidence density of 2.3 episodes per 1000 days of hospitalization. The most frequent locations were the heels followed by the buttocks. In multivariate analysis, polytrauma (p=0.048) and disorders of higher functions (p<10-3) were found as independent risk factors for pressure ulcer occurrence. Regarding the evaluation of different pressure screening scores, Braden had the best sensitivity-specificity pair. Conclusion: Our results highlight the extent of the problem of pressure ulcers in our hospital. The fight against the occurrence of this complication requires a good management of traumatized and patients with a disorder of the higher functions based on the recommendations concerning the rehabilitation and the nutrition.