Sodoma Andrej M, Shain Spencer, Naseeb Muhammad Wahdan, Greenberg Samuel, Skulikidis Argirios, Arshad Sadia
Internal Medicine, South Shore University Hospital, Bay Shore, USA.
Urology, New York Institute of Technology College of Osteopathic Medicine (NYITCOM), Old Westbury, USA.
Cureus. 2024 Oct 8;16(10):e71097. doi: 10.7759/cureus.71097. eCollection 2024 Oct.
Pressure ulcer injuries (PIs) are ischemic changes to the skin caused by long-term pressure on bony prominences. This study aimed to investigate the prevalence of PIs and their effects on minority groups in the hospital setting in the United States.
The National Inpatient Sample (NIS) from 2011 to 2020 was used to identify adults hospitalized in the United States who received a diagnosis of PI. International Classification of Diseases, Ninth Revision (ICD-9) and Tenth Revision (ICD-10) codes were used to select patients. An equal number of random records, stratified by year and without a diagnosis of PI, were selected to serve as controls. Records were analyzed for baseline characteristics using a chi-square test.
Adjusted odds ratios (ORs) of developing a pressure ulcer were calculated using multivariate logistic regression, a weighted total of 5,993,667 PI admissions were included in this study, and 5,993,667 non-PI admissions were included. PI patients were more likely than controls to be male (OR = 0.88; 95% confidence interval {CI}: 0.88, 0.89; p < 0.05). PI patients were more likely to be older than non-PI patients (75+ years; OR = 3.46; 95% CI: 3.38, 3.54; p < 0.05). PI patients were more likely to be on Medicare or Medicaid (OR = 1.94; 95% CI: 1.92, 1.97; p < 0.05) than private insurance. PI patients were far more likely to have a high Charlson Comorbidity Index (CCI) of 3+ (OR = 10.44; 95% CI: 10.18, 10.71; p < 0.05) than a lower CCI score. Compared to Whites, African Americans (OR = 1.49; 95% CI: 1.47, 1.51; p < 0.05) were at higher risk of PIs. Among PI patients, White patients had a lower risk of death compared to African Americans (OR = 1.09; 95% CI: 1.07, 1.11; p < 0.05). African Americans had lower rates of acute kidney injury (AKI) compared to Whites (OR = 0.88; 95% CI: 0.86, 0.91; p < 0.05). Compared to Whites, rates of sepsis were higher for African Americans (OR = 1.40; 95% CI: 1.38, 1.42; p < 0.05).
A racial discrepancy in pressure ulcer prevalence was shown in racial minorities, particularly African Americans. It is essential to address this difference in diagnosis to improve outcomes among racial minorities.
压疮损伤（PIs）是由骨隆突处长期受压引起的皮肤缺血性改变。本研究旨在调查美国医院环境中压疮的患病率及其对少数群体的影响。
使用2011年至2020年的全国住院患者样本（NIS）来识别在美国住院并被诊断为压疮的成年人。使用国际疾病分类第九版（ICD-9）和第十版（ICD-10）编码来选择患者。选择数量相等的按年份分层且未诊断为压疮的随机记录作为对照。使用卡方检验分析记录的基线特征。
使用多变量逻辑回归计算发生压疮的调整优势比（OR），本研究纳入了加权总计5993667例压疮入院病例和5993667例非压疮入院病例。与对照组相比，压疮患者更可能为男性（OR = 0.88；95%置信区间{CI}：0.88，0.89；p < 0.05）。压疮患者比非压疮患者更可能年龄较大（75岁及以上；OR = 3.46；95% CI：3.38，3.54；p < 0.05）。与私人保险相比，压疮患者更可能参加医疗保险或医疗补助（OR = 1.94；95% CI：1.92，1.97；p < 0.05）。与较低的Charlson合并症指数（CCI）评分相比，压疮患者的CCI评分为3分及以上的可能性要高得多（OR = 10.44；95% CI：10.18，10.71；p < 0.05）。与白人相比，非裔美国人发生压疮的风险更高（OR = 1.49；95% CI：1.47，1.51；p < 0.05）。在压疮患者中，白人患者的死亡风险低于非裔美国人（OR = 1.09；95% CI：1.07，1.11；p < 0.05）。与白人相比，非裔美国人的急性肾损伤（AKI）发生率较低（OR = 0.88；95% CI：0.86，0.91；p < 0.05）。与白人相比，非裔美国人的败血症发生率更高（OR = 1.40；95% CI：1.38，1.42；p < 0.05）。
少数族裔，尤其是非裔美国人，在压疮患病率方面存在种族差异。解决这种诊断差异对于改善少数族裔的治疗结果至关重要。
