Department of Psychiatry, College of Medicine, Charles R. Drew University of Medicine and Science and UCLA David Geffen School of Medicine, Los Angeles, CA, USA.
College of Medicine, Charles R. Drew University of Medicine and Science and UCLA David Geffen School of Medicine, Los Angeles, CA, USA.
Medicine (Baltimore). 2023 Oct 6;102(40):e35307. doi: 10.1097/MD.0000000000035307.
In the United States (US), pressure ulcers affect ≤3 million people and costs exceed 26.8 billion US dollars in spending. To examine trends in primary pressure ulcer (PPU) hospitalization mortality, length of hospital stay (LOS), and inflation-adjusted charges (IAC) in the US from 2005 to 2014 by race/ethnicity. We secondarily examined the relationship between race/ethnicity with PPU mortality, LOS, and IAC with race/ethnicity. This cross-sectional study used Nationwide Inpatient Sample (NIS) data from 2005 to 2014. The study sample included all hospitalizations with the designated ICD-9-CM code of 707.20-25 (pressure ulcer). There was a notable decline in PPU hospitalization from 11.5% to 7.77 % between 2005 and 2014. The mean mortality decreased from 2.32% to 1.12% (P < .001), the mean LOS declined from 9.39 days (P < .001), and the mean IAC per hospitalization decreased from $30,935 to $29,432 (P < .001). Positive changes observed in mortality, LOS, and IAC trends were consistent across different racial and ethnic groups. The results of multivariable logistic and linear regression analyses revealed that Black patients (β = 0.68, 95% CI 0.36-1.01, P < .001) and patients belonging to the Other race/ethnic category (β = 0.93, 95% CI 0.18-1.69) had longer hospital stays compared to their White counterparts. Regarding IAC, Black patients (β = 2846, 95% CI 1254-4439, P < .005), Hispanic patients (β = 6527, 95% CI 4925-8130), and patients from the Other race/ethnic category (β = 3473, 95% CI 1771-5174) had higher IAC for PPU treatment compared to their White counterparts. PPU hospitalization discharges, as well as hospitalization mortality, LOS, and IAC, decreased during the study period, however, our findings revealed disparities in PPU outcomes among different racial/ethnic groups. Implications of the findings are discussed.
在美国，压疮影响了≤300 万人，支出超过 268 亿美元。本研究旨在分析 2005 年至 2014 年期间按种族/族裔划分的美国原发性压疮（PPU）住院死亡率、住院时间（LOS）和通胀调整费用（IAC）的趋势。我们还次要地检查了种族/族裔与 PPU 死亡率、LOS 和 IAC 与种族/族裔之间的关系。本横断面研究使用了 2005 年至 2014 年全国住院患者样本（NIS）数据。研究样本包括所有被指定 ICD-9-CM 代码 707.20-25（压疮）的住院患者。2005 年至 2014 年间，PPU 住院率从 11.5%显著下降至 7.77%。死亡率从 2.32%下降至 1.12%（P<.001），平均住院时间从 9.39 天下降（P<.001），每例住院患者的平均 IAC 从 30935 美元降至 29432 美元（P<.001）。不同种族和族裔群体的死亡率、LOS 和 IAC 趋势均呈积极变化。多变量逻辑和线性回归分析的结果表明，与白人患者相比，黑人患者（β=0.68，95%CI 0.36-1.01，P<.001）和其他种族/族裔类别的患者（β=0.93，95%CI 0.18-1.69）的住院时间更长。关于 IAC，与白人患者相比，黑人患者（β=2846，95%CI 1254-4439，P<.005）、西班牙裔患者（β=6527，95%CI 4925-8130）和其他种族/族裔类别的患者（β=3473，95%CI 1771-5174）的 PPU 治疗 IAC 更高。研究期间，PPU 住院出院人数以及住院死亡率、LOS 和 IAC 均有所下降，但我们的研究结果显示不同种族/族裔群体的 PPU 结局存在差异。讨论了研究结果的意义。
