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西班牙加泰罗尼亚地区住院患者慢性伤口的患病率:一项多中心横断面描述性观察研究

Prevalence of chronic wounds in hospitalised patients in Catalonia, Spain: a multicentre cross-sectional descriptive observational study.

作者信息

López-Jiménez María Magdalena, Romero-García Marta, Adamuz Jordi, Berbis-Morelló Carmen, Pons-Prats Mònica, Tapia-Pérez Marta, Zuriguel Pérez Esperanza, Castro-Navarro Trinidad, Juvé-Udina Maria-Eulàlia, González-Samartino Maribel

机构信息

Department of Nursing knowledge Management and Information Systems, Bellvitge University Hospital, L'Hospitalet de Llobregat, Catalunya, Spain.

Department of Fundamental and Clinical Nursing, University of Barcelona, Barcelona, Spain.

出版信息

BMJ Open. 2025 May 28;15(5):e095542. doi: 10.1136/bmjopen-2024-095542.

Abstract

BACKGROUND

Few studies have investigated the prevalence of chronic wounds and the clinical and sociodemographic characteristics of hospitalised patients affected by them. Understanding these characteristics within the inpatient setting can support improved follow-up, inform care strategies, enhance quality and safety and reduce associated healthcare costs. This study aimed to determine the prevalence and the sociodemographic profile of adult inpatients with chronic wounds admitted to the eight hospitals of the Catalan Institute of Health between 2016 and 2020.

METHODS

A descriptive, observational, cross-sectional and retrospective multicentre study was conducted using routinely collected clinical data from 1 January 2016 to 31 December 2020. The study encompassed hospital wards, step-down units and home hospitalisation services across eight public hospitals managed by the Catalan Institute of Health, the main public healthcare provider in Catalonia, Spain. The study included all patients aged 18 years or older who were hospitalised with chronic wounds during the study period. The main variables were nursing diagnoses of chronic wound types: pressure injuries (PIs), arterial ulcers (AUs), venous ulcers (VUs), mixed ulcers and diabetic foot ulcers (DFUs), as recorded in nursing electronic health records. Secondary variables included age, sex, reason for admission, unit of admission, hospital type, source of admission and discharge destination. A descriptive and comparative analysis was performed.

RESULTS

Among 796 698 hospitalised patients, 16 935 (2.1%) presented with at least one chronic wound. The most common types of chronic wounds were PIs and AUs. A slight decline in the prevalence of chronic wounds was observed over the study period. Cardiovascular and respiratory conditions were the leading causes of admission among these patients. AUs and DFUs were more prevalent in men, whereas VUs were more frequently observed in women. Patients with PIs had longer hospital stays, higher rates of intensive care unit admissions and increased in-hospital mortality. In contrast, patients with vascular ulcers more often required continued care after discharge (p<0.001).

CONCLUSIONS

Chronic wounds continue to represent a significant healthcare challenge. It is essential to consider the clinical characteristics and health outcomes of hospitalised patients with chronic wounds in order to improve care quality and safety. Further research is warranted to explore the relationship between patient care complexity and the type of chronic wounds present.

摘要

背景

很少有研究调查慢性伤口的患病率以及受其影响的住院患者的临床和社会人口学特征。了解住院患者的这些特征有助于改善随访、为护理策略提供依据、提高质量和安全性并降低相关医疗成本。本研究旨在确定2016年至2020年期间加泰罗尼亚卫生研究所八家医院收治的成年慢性伤口住院患者的患病率和社会人口学概况。

方法

采用2016年1月1日至2020年12月31日期间常规收集的临床数据进行描述性、观察性、横断面和回顾性多中心研究。该研究涵盖了加泰罗尼亚卫生研究所管理的八家公立医院的病房、逐步降级病房和家庭住院服务,加泰罗尼亚卫生研究所是西班牙加泰罗尼亚的主要公共医疗服务提供者。该研究纳入了研究期间因慢性伤口住院的所有18岁及以上患者。主要变量是护理电子健康记录中记录的慢性伤口类型的护理诊断:压力性损伤(PIs)、动脉溃疡(AUs)、静脉溃疡(VUs)、混合溃疡和糖尿病足溃疡(DFUs)。次要变量包括年龄、性别、入院原因、入院科室、医院类型、入院来源和出院目的地。进行了描述性和比较性分析。

结果

在796698名住院患者中,16935名(2.1%)至少有一处慢性伤口。最常见的慢性伤口类型是PIs和AUs。在研究期间观察到慢性伤口患病率略有下降。心血管和呼吸系统疾病是这些患者入院的主要原因。AUs和DFUs在男性中更为普遍,而VUs在女性中更常见。患有PIs的患者住院时间更长,重症监护病房入院率更高,住院死亡率也更高。相比之下,血管溃疡患者出院后更常需要持续护理(p<0.001)。

结论

慢性伤口仍然是一个重大的医疗挑战。必须考虑慢性伤口住院患者的临床特征和健康结局,以提高护理质量和安全性。有必要进一步研究以探索患者护理复杂性与现有慢性伤口类型之间的关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/11f8/12121581/d76be54ecffc/bmjopen-15-5-g001.jpg

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