Association between pressure injury status and hospital discharge to home: a retrospective observational cohort study using a national inpatient database

Abstract

a BStra ct BacKgrOUnDS The presence of pressure injuries may affect patient discharge destination; however, no related large-scale survey has been conducted in Japan. This study aimed to evaluate the association between pressure injury status and discharge to home from Japanese acute-care hospitals. MetHODS This retrospective observational cohort study used the Japanese Diagnosis Procedure Combination database from July 1 to 31, 2014. We assessed 340,124 inpatients aged 65 years or older admitted from home. To examine the association between pressure injury status (none, healed, healing, stable, worsened, or developed) and home discharge, we employed multi-variable logistic regressions; these were adjusted for patient characteristics and within-hospital clustering using generalized estimating equations. reSUltS The prevalence of pressure injuries on admission was 1.9%; the overall proportion of hospital-acquired pressure injuries was 1.1%. The logistic regression analyses showed patients with superficial or deep pressure injuries were less likely to be discharged to home. Furthermore, poor pressure injury status (developed < worsened < stable < healing < healed) was associated with lower likelihood of discharge to home. cOnclUSiOnS Poor pressure injury status negatively affected hospital discharge destination among elderly patients admitted from home.