Retrospective analysis of pressure sore risk factors in patients hospitalized in the palliative care center of Ordu University Training and Research Hospital

Objective: This study was conducted to determine the demographic, clinical, functional, hematological, and biochemical risk factors affecting the development of pressure ulcers in patients hospitalized at the Palliative Care Center of Ordu University Training and Research Hospital. The study aims to contribute to the prevention of pressure ulcers, which are frequently encountered in the palliative care process, and to the early identification of at-risk patients. Materials and Methods: This retrospective, descriptive study was conducted by reviewing the medical records of 200 patients followed at the Palliative Care Center between April 1, 2023, and March 31, 2024. Individuals aged 18 years and older, hospitalized for at least 72 hours, and with complete medical records were included in the study. Participants were divided into two groups: those with pressure ulcers (n=100) and those without pressure ulcers (n=100). In between-group comparisons, the Independent Samples t-test was used for normally distributed variables, the Pearson chi-square test for categorical variables, or Fisher's exact chi-square test when appropriate. Non-parametric methods were preferred for continuous variables that did not show a normal distribution. Relationships between continuous variables were assessed using Spearman's rank correlation. P<0.05 was considered statistically significant. Findings: The mean age was 75.76±15.11 years, and the age was significantly higher in the group with pressure ulcers. Patients with pressure ulcers had longer hospital stays, and KPS was significantly lower (p<0.001). The presence of Alzheimer's/dementia (52.0%) (p<0.001) and hypertension (72.0%) (p<0.013) were significantly associated with pressure ulcers. Additionally, the rates of fecal incontinence (92.0%) (p<0.001) and PEG/NG feeding (33.0%) (p<0.003) were vi significantly higher in the pressure ulcer group. Laboratory findings showed that low hemoglobin, hematocrit, sodium, albumin, and total protein levels were associated with pressure ulcer development. Univariate logistic regression analysis identified age, length of stay, low KPS, hypoalbuminemia, hyponatremia, anemia, and high BUN and HbA1c levels as significant risk factors for pressure ulcer development. Multivariate analysis revealed the presence of Alzheimer's/dementia and high HbA1c levels as independent risk factors. Conclusion: The findings suggest that pressure ulcer development in palliative care patients is a multifaceted process, and both clinical and biochemical factors play an important role in this process. These results highlight the need for individualized follow-up in palliative care, regular monitoring of metabolic and nutritional parameters, preservation of skin integrity, and strengthening of a multidisciplinary approach.