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

  • Marcos Antonio neves Noronha
  • Dov Charles Goldenberg
  • Marina Vilela Chagas Ferreira
  • Rafael Ferreira Zatz
  • Francisco Tustumi

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

1. Gefen A, Ousey K. COVID-19, fever and dressings used for pressure ulcer prevention: monthly update. Journal of Wound Care. 2020;29(8):430-431.
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.
Published
2022-01-26
How to Cite
NORONHA, Marcos Antonio neves et al. 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. International Archives of Medicine, [S.l.], v. 15, jan. 2022. ISSN 1755-7682. Available at: <http://imedicalpublisher.com/ojs/index.php/iam/article/view/2940>. Date accessed: 01 june 2023. doi: https://doi.org/10.3823/2636.
Section
Epidemiology

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