Lahmann N, Dassen T, Kottner J
Institut für Medizin-/Pflegepädagogik und Pflegewissenschaft, Charité - Universitätsmedizin Berlin, Berlin.
Gesundheitswesen. 2012 Dec;74(12):793-7. doi: 10.1055/s-0031-1299778. Epub 2012 Feb 9.
The prevalence and incidence of pressure ulcers are increasingly used to assess the quality of care delivered by health systems and facilities and the effectiveness of the pressure ulcer prevention initiatives in place. Available results about pressure ulcer prevalence and incidence in German hospitals are contradictory. The comparison of 3 multicentre nationwide studies is proposed to provide a more accurate estimation of the pressure ulcer frequency. Pressure ulcer prevalence was compared by data provided by the Charité with data of the software-based data collection packet "Kinexus". Additionally, data on pressure ulcer incidence of Kinexus were compared with the results of the incidence data of the "Generalindikator Dekubitusprophylaxe" of the German Society of Quality Assurance (BQS, now AQUA Institute). Data from 2007 and 2008 and patients 75 years and older were considered. For the calculation of the outcome "pressure ulcer" recommendations of the EPUAP and the NPUAP were followed. As category I (non-bleaching erythema) pressure ulcers are difficult to diagnose, all proportions were calculated including and excluding category I. All 3 samples were comparable regarding the mean age of 81 years. Pressure ulcer prevalence categories I-IV (II-IV) of the Kinexus study was 11.8% (6.1%) and of the Charité study it was 11.0% (5.5%). Regarding pressure ulcer incidence, the rate that was calculated by the BQS categories I-IV (II-IV) was 1.3% (0.8%), in comparison to the incidence rate of Kinexus which was 6.7% (3.9%). There were no statistically significant differences between the 2 prevalence measurements but the odds-ratio of the Kinexus incidence in comparison to the BQS incidence was more than 4 times higher (p<0.001). Results of the Kinexus study are more comparable to incidence figures of international studies on pressure ulcer incidence. The results of this secondary data analysis indicate that published incidence figures by the BQS (now AQUA Institute) might be underestimated. Since this measurement is expensive and burdensome, this mandatory procedure is questionable.
压疮的患病率和发病率越来越多地用于评估卫生系统和医疗机构提供的护理质量以及现有压疮预防措施的有效性。关于德国医院压疮患病率和发病率的现有结果相互矛盾。建议对3项全国性多中心研究进行比较，以更准确地估计压疮发生率。通过夏里特医院提供的数据与基于软件的数据收集包“Kinexus”的数据比较压疮患病率。此外，将Kinexus的压疮发病率数据与德国质量保证协会（BQS，现为AQUA研究所）的“压疮预防通用指标”的发病率数据结果进行比较。考虑了2007年和2008年的数据以及75岁及以上的患者。为计算“压疮”结果，遵循了欧洲压疮咨询小组（EPUAP）和美国国家压疮咨询小组（NPUAP）的建议。由于I类（非苍白性红斑）压疮难以诊断，所有比例的计算均包括和不包括I类。所有3个样本在平均年龄81岁方面具有可比性。Kinexus研究中I-IV（II-IV）类压疮患病率为11.8%（6.1%），夏里特医院研究中为11.0%（5.5%）。关于压疮发病率，BQS计算的I-IV（II-IV）类发病率为1.3%（0.8%），而Kinexus的发病率为6.7%（3.9%）。两项患病率测量结果之间无统计学显著差异，但Kinexus发病率与BQS发病率的比值比高出4倍多（p<0.001）。Kinexus研究结果与国际压疮发病率研究的发病率数据更具可比性。这项二次数据分析结果表明，BQS（现为AQUA研究所）公布的发病率数据可能被低估了。由于这种测量成本高且负担重，这种强制性程序值得怀疑。
