Ferris A, Price A, Harding K, et al.
Palliative medicine. Date of publication 2019 Apr 24;volume ():269216319846023.
1. Palliat Med. 2019 Apr 24:269216319846023. doi: 10.1177/0269216319846023. [Epub
ahead of print]
Pressure ulcers in patients receiving palliative care: A systematic review.
Ferris A(1), Price A(1), Harding K(1).
Author information:
(1)Welsh Wound Innovation Centre, Pontyclun, UK.
BACKGROUND: Pressure ulcers are associated with significant morbidity and
mortality as well as high cost to the health service. Although often linked with
inadequate care, in some patients, they may be unavoidable.
AIM: This systematic review aims to quantify the prevalence and incidence of
pressure ulcers in patients receiving palliative care and identify the risk
factors for pressure ulcer development in these patients as well as the temporal
relationship between pressure ulcer development and death.
DESIGN: The systematic review is registered in the PROSPERO database
(CRD42017078211) and conducted in accordance with the 'PRISMA' pro forma.
Articles were reviewed by two independent authors.
DATA SOURCES: MEDLINE (1946-22 September 2017), EMBASE (1996-22 September 2017),
CINAHL (1937-22 September 2017) and Cochrane Library databases were searched. In
all, 1037 articles were identified and 12 selected for analysis based on
pre-defined inclusion and exclusion criteria.
RESULTS: Overall pressure ulcer prevalence and incidence were found to be 12.4%
and 11.7%, respectively. The most frequently identified risk factors were
decreased mobility, increased age, high Waterlow score and long duration of stay.
CONCLUSION: The prevalence of pressure ulcers is higher in patients receiving
palliative care than the general population. While this should not be an excuse
for poor care, it does not necessarily mean that inadequate care has been
provided. Skin failure, as with other organ failures, may be an inevitable part
of the dying process for some patients.
DOI: 10.1177/0269216319846023
PMID: 31018829
