Table 4. Risk of 30-day postoperative in-hospital mortality associated with preoperative characteristics of pressure ulcer.
| Characteristics of pressure ulcer within preoperative 24 months | 30-day postoperative mortality | ||||
|---|---|---|---|---|---|
| n | Deaths | Mortality, % | RR | (95% CI)* | |
| Controls without pressure ulcer | 17391 | 198 | 1.1 | 1.00 | (reference) |
| Patients with pressure ulcer | |||||
| Antibiotics total quantity, mg† | |||||
| Low | 15280 | 302 | 2.0 | 1.74 | (1.46–2.08) |
| Moderate | 706 | 14 | 2.0 | 1.74 | (1.01–2.99) |
| High | 701 | 19 | 2.7 | 2.26 | (1.41–3.62) |
| Very high | 704 | 28 | 4.0 | 3.46 | (2.33–5.15) |
| Medical expenditure of antibiotics† | |||||
| Low | 15264 | 302 | 2.0 | 1.75 | (1.47–2.10) |
| Moderate | 704 | 16 | 2.3 | 1.91 | (1.15–3.19) |
| High | 1408 | 45 | 3.2 | 2.60 | (1.88–3.60) |
| Types of antibiotics | |||||
| Without antibiotics | 14805 | 300 | 2.0 | 1.79 | (1.50–2.14) |
| With first-line antibiotics (stage ≥2)‡ | 2586 | 63 | 2.4 | 2.06 | (1.55–2.74) |
| With second-line antibiotics (stage ≥2)‡ | 412 | 19 | 4.6 | 3.74 | (2.33–5.99) |
| Pressure ulcer with local infection | |||||
| No | 14624 | 302 | 2.1 | 1.81 | (1.51–2.16) |
| Yes (stage ≥2)‡ | 2767 | 61 | 2.2 | 1.97 | (1.48–2.63) |
| Pressure ulcer with cellulitis | |||||
| No | 12532 | 265 | 2.1 | 1.81 | (1.51–2.18) |
| Yes (stage ≥2)‡ | 4859 | 98 | 2.0 | 1.89 | (1.48–2.41) |
| Preoperative hospitalized care for PU | |||||
| No | 13797 | 296 | 2.2 | 1.82 | (1.52–2.18) |
| Yes (stage ≥2)‡ | 3594 | 67 | 1.9 | 1.90 | (1.43–2.52) |
| Pressure ulcer with wound | |||||
| No | 12236 | 241 | 2.0 | 1.73 | (1.44–2.09) |
| Yes (stage ≥2)‡ | 5155 | 122 | 2.4 | 2.07 | (1.65–2.60) |
| Pressure ulcer with debridement | |||||
| No | 13728 | 284 | 2.1 | 1.79 | (1.49–2.15) |
| Yes (stage ≥3)‡ | 3663 | 79 | 2.2 | 2.01 | (1.55–2.61) |
| Pressure ulcer with change dressing | |||||
| No | 4794 | 82 | 1.7 | 1.63 | (1.26–2.12) |
| Yes (stage ≥2)‡ | 12597 | 281 | 2.2 | 1.90 | (1.59–2.28) |
| Moderate-to-severe pressure ulcer§ | |||||
| No (stage = 1)‡ | 2852 | 42 | 1.5 | 1.37 | (0.98–1.91) |
| Yes (stage ≥2)‡ | 14539 | 321 | 2.2 | 1.92 | (1.61–2.29) |
CI, confidence interval; PU, pressure ulcer; RR, rate ratio.
*Adjusted for age, sex, low income, urbanization, coexisting medical conditions, operation in teaching hospital, types of anesthesia and types of surgery.
†Antibiotics total quantity was categorized into low (non-antibiotics users and lowest quartile), moderate (second quartile), high (third quartile), and very high (highest quartile). Medical expenditure of antibiotics was categorized into low (non-antibiotics users and lowest quartile), moderate (second quartile), and high (third quartile and highest quartile)
‡Based on the criteria of The National Pressure Ulcer Advisory Panel, the stage of pressure ulcer was categorised by clinical physicians in Taiwan and previous investigations.
§Patients with pressure have at least one of characteristics, such as debridement, local infection, cellulitis, wound, change dressing, use of antibiotics, and hospitalized care.