Pressure Injuries in Inpatient Care Facilities in the Czech Republic: Analysis of a National Electronic Database

J Wound Ostomy Continence Nurs. 2017 Jul/Aug;44(4):331-335. doi: 10.1097/WON.0000000000000344.


Purpose: The purpose of this study was to analyze pressure injury (PI) occurrence upon admission and at any time during the hospital course inpatients care facilities in the Czech Republic. Secondary aims were to evaluate demographic and clinical data of patients with PI and the impact of a PI on length of stay (LOS) in the hospital.

Design: Retrospective, cross-sectional analysis.

Setting and subjects: The sample comprised data of hospitalized patients entered into the National Register of Hospitalized Patients (NRHOSP) database of the Czech Republic between 2007 and 2014 with a diagnosis L89 (pressure ulcer of unspecified site based on the International Classification of Diseases, Tenth Revision, ICD-10). Electronic records of 17,762,854 hospitalizations were reviewed.

Method: Data from the NRHOSP from all acute and non-acute care hospitals in the Czech Republic were analyzed. Specifically, we analyzed patients admitted to acute and non-acute care facilities with a primary or secondary diagnosis of PI.

Results: The NRHOSP database included 17,762,854 cases, of which 46,224 cases (33,342 cases in acute care hospitals; 12,882 in non-acute care hospitals) had the L89 diagnosis (0.3%). The mean age of patients admitted with a PI was 73.8 ± 15.3 years (mean ± SD), and their average LOS was 33.2 ± 76.9 days. The mean LOS of patients hospitalized with L89 code as a primary diagnosis (n = 6877) was significantly longer compared to those patients for whom L89 code was a secondary diagnosis (25.8 vs 20.2 days, P < .001) in acute care facilities. In contrast, we found no difference in the mean LOS for patients hospitalized in non-acute care facility (58.7 days vs 65.1 days; P = .146) with ICD code L89.

Conclusion: Pressure injuries were associated with significant LOS in both acute and non-acute care settings in the Czech Republic. Despite the valuable insights we obtained from the analysis of NRHOSP data, we advocate creation of a more valid and reliable electronic reporting system that enables policy makers to evaluate the quality and safety concerning PI and its impact on patients and the healthcare system.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cross-Sectional Studies
  • Czech Republic
  • Databases, Factual / standards*
  • Databases, Factual / statistics & numerical data
  • Female
  • Hospitals / standards
  • Hospitals / statistics & numerical data
  • Humans
  • Inpatients / statistics & numerical data*
  • Male
  • Middle Aged
  • Pressure Ulcer / classification
  • Pressure Ulcer / epidemiology*
  • Pressure Ulcer / nursing
  • Retrospective Studies
  • Statistics, Nonparametric