Incidence of intra-hospital care related to pressure ulcers and the influence of the COVID-19 pandemic in the city of São Paulo, from March to December 2020
Abstract
Background: In Brazil, there is no published article that measures the expense of this condition for the health system. There are international studies that show that treating a pressure ulcer is significantly more expensive than preventing it. The purpose of this article is to describe the incidence of patients with hospitalization related to pressure ulcers, in the city of São Paulo, in the period of the 1st increase in cases of COVID - 19 (March 2020 to December 2020), as well as the related expense with these hospitalizations.
Method and Findings: Through the TABNET knowledge and public data platform, detailed data on the AIH were selected - by place of hospitalization - São Paulo, in the main procedure field, using the selection of the municipality of São Paulo in the platform line. The data, specifically, from three institutions were studied. Data were also collected from these hospitals and from the city of São Paulo, referring to the average number of days of hospitalization and the total value of the AIH. The study was retrospective, longitudinal, grouped, of the ecological type.
All values found referred to the SUS code 0415040035 (debridement of ulcer/devitalized tissues). A total of 2,832 cases were found, with an approximate average of 283.2 monthly cases; the month with the lowest incidence was December 2020 with 205 cases and the month with the highest incidence was March 2020 with 405 cases. With a total expense of 4,238,625.57 with an average value of RS 423,862.55.
Conclusion: There is also a high cost of SUS, with preventable morbidity and cost reduction. There is no tendency for costs to fall, despite the decrease in incidence.
References
2. Nani F, Stéfani K, Busnardo F, Monteiro G, Santos M, John V et al. Ulcer pressure prevention and opportunity for innovation during the COVID-19 crisis. Clinics. 2020;75.
3. Girard R, Baboi L, Ayzac L, Richard J, Guérin C. The impact of patient positioning on pressure ulcers in patients with severe ARDS: results from a multicentre randomised controlled trial on prone positioning. Intensive Care Medicine. 2013;40(3):397-403.
4. Bloomfield R, Noble D, Sudlow A. Prone position for acute respiratory failure in adults. Cochrane Database of Systematic Reviews. 2015;2020(11).
5. Waller H, McCarthy M, Goverman J, Kaafarani H, Dua A. Wound care in the era of COVID-19. Journal of Wound Care. 2020;29(8):432-434.
6. Tang J, Li B, Gong J, Li W, Yang J. Challenges in the management of critical ill COVID ‐19 patients with pressure ulcer. International Wound Journal. 2020;17(5):1523-1524.
7. Moore Z, Patton D, Avsar P, McEvoy N, Curley G, Budri A et al. Prevention of pressure ulcers among individuals cared for in the prone position: lessons for the COVID-19 emergency. Journal of Wound Care. 2020;29(6):312-320.
8. Dryburgh N, Smith F, Donaldson J, Mitchell M. Debridement for surgical wounds. Cochrane Database of Systematic Reviews. 2008;.
9. Cardinal M, Eisenbud D, Armstrong D, Zelen C, Driver V, Attinger C et al. Serial sur-gical debridement: A retrospective study on clinical outcomes in chronic lower extremity wounds. Wound Repair and Regeneration. 2009;17(3):306-311.
10. Brem H, Stojadinovic O, Diegelmann R, Entero H, Lee B, Pastar I et al. Molecular Markers in Patients with Chronic Wounds to Guide Surgical Debridement. Molecular Medicine. 2007;13(1-2):30-39.
11. Schiffman J, Golinko M, Yan A, Flattau A, Tomic-Canic M, Brem H. Operative De-bridement of Pressure Ulcers. World Journal of Surgery. 2009;33(7):1396-1402.
12. Lichterfeld-Kottner A, Hahnel E, Blume-Peytavi U, Kottner J. Systematic mapping re-view about costs and economic evaluations of skin conditions and diseases in the aged. Journal of Tissue Viability. 2017;26(1):6-19.
13. Woodhouse M, Worsley P, Voegeli D, Schoonhoven L, Bader D. How consistent and effective are current repositioning strategies for pressure ulcer prevention?. Applied Nursing Research. 2019;48:58-62.
14. Mervis J, Phillips T. Pressure ulcers: Pathophysiology, epidemiology, risk factors, and presentation. Journal of the American Academy of Dermatology. 2019;81(4):881-890.
15. Demarré L, Van Lancker A, Van Hecke A, Verhaeghe S, Grypdonck M, Lemey J et al. The cost of prevention and treatment of pressure ulcers: A systematic review. Interna-tional Journal of Nursing Studies. 2015;52(11):1754-1774.
16. Ministério da Economia. Ipeadata [Internet]. Ipeadata.gov.br. 2021 [cited 4 August 2021]. Available from: http://www.ipeadata.gov.br/ExibeSerie.aspx?serid=31924
17. Hashim M, Alsuwaidi A, Khan G. Population Risk Factors for COVID-19 Mortality in 93 Countries. Journal of Epidemiology and Global Health. 2020;10(3):204.
18. Hajhosseini B, Longaker M, Gurtner G. Pressure Injury. Annals of Surgery. 2020;271(4):671-679.
19. Dealey C, Posnett J, Walker A. The cost of pressure ulcers in the United Kingdom. Journal of Wound Care. 2012;21(6):261-266.
20. Bauer K, Rock K, Nazzal M, Jones O, Qu W. Pressure Ulcers in the United States' In-patient Population From 2008 to 2012: Results of a Retrospective Nationwide Study. Ostomy Wound Manage [Internet]. 2016 [cited 4 August 2021];62(11). Available from: https://www.hmpgloballearningnetwork.com/site/wmp/issue/3501
21. Smith N. The benefits of VAC therapy in the management of pressure ulcers. British Journal of Nursing. 2004;13(22):1359-1365.

This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright policies & self-archiving
We are a RoMEO green journal.
Author's Pre-print: author can archive pre-print (ie pre-refereeing)
Author's Post-print: author can archive post-print (ie final draft post-refereeing)
Publisher's Version/PDF: author can archive publisher's version/PDF
Copyright ownership
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access and Benefits of Publishing Open Access).
This journal provides immediate open access to its content on the principle that making research freely available to the public supports a greater global exchange of knowledge.
Articles are published Under License of Creative Commons Attribution 4.0 License © Copyright Policy
Any permissions should be requested to PLSclear.com