(CR-031) Age as a Prognostic Tool in Outcomes of Advanced Pressure Ulcers

Nicole Rossi, n/a – Rush Medical College; Nicole Siparsky, MD, FACS, FCCM – Rush University Medical Center

Introduction: Pressure ulcers (PU) continue to disproportionately affect chronically ill patients with limited mobility. Despite the high incidence of PU, there remains a lack of information available on outcomes of patients with PU. Similarly, it remains unclear what impact, if any, demographic factors, such as age, have on PU outcome. Without this information, it is difficult for providers to accurately inform patients of what to expect, including the postoperative quality of life and likelihood of PU closure.

Methods: We performed a retrospective study under Institutional Review Board approval (ORA #: 21112101-IRB01). Patients diagnosed with stages 3 and 4 PU of the sacrum, ischium, trochanter, leg, chest, and back were identified. These patients underwent surgical debridement of their PU with the Acute Care Surgery Service at Rush University Medical Center between 2017 and 2022. Both demographic and clinical information was collected.

Results: We identified 76 patients who fit the inclusion criteria for the study. The study population was organized into the following age groups (in years): < 20 (1.3%), 20-29 (1.3%), 30-39 (15.8%), 40-49 (9.0%), 50-59 (18.4%), 60-69 (15.8%), 70-79 (21.1%), 80-89 (13.2%), and 90-99 (3.9%). One PU achieved closure by 3 months among those 50-59; 1 additional PU achieved closure by 6 months in this age group. Another PU achieved closure by 6 months among those in the 40-49 age group.

Discussion: This study highlights the poor prognosis of PU based on patient age. Closure of advanced PU across all age groups was rare; no patients ages 60+ had achieved PU closure by 2 years despite those patients representing >50% of the population examined. Long-term follow up was poor across all age groups. The greatest rates of short-term follow up were observed in those 40-49 and 50-59, which may coincide with their success in PU closure. For most patients with advanced pressure ulcers, especially those age 60+, an advanced PU becomes a chronic problem that they will live with for years to come, with early closure being a rare event.