Evaluation of Pressure ulcers : a prospective cohort study

The objective of this study is to evaluate the clinical and microbiological characteristics of pressure ulcers and factors associated with mortality. This study was a prospective observational cohort study of patients at GSVM College and LLR hospital between February 2022 to December 2025. Thirty patients were included. The incidence of pressure ulcers increased from 1.10 cases per 10,000 hospital discharges in the period from 1984 to 1999 to 3.1 cases per 10,000 hospital discharges in the period from 2022 to 2025 ( p > 0.001). In 20 cases (80%), the occurence of pressure ulcers was hospital-acquired, since it occurred more than 48 h after the hospital admission. The most frequent microorganisms isolated in wound culture were Staphylococcus aureus , Proteus spp., and Bacteroides spp. The microbial infection were polymicrobial in 10 cases (20.0%). The risk factors independently associated with mortality were hospital-acquired bacteremia (odds ratio [OR] 5.51, 95% confidence interval [95%CI] 1.24–24.40), polymicrobial bacteremia (OR 6.88, 95%CI 1.22–38.89), and serum albumin <23 g/L (OR 8.00, 95%CI 1.73–37.01). Polymicrobial bacteremia s an uncommon complication of pressure ulcers and is mainly caused by S. aureus , Proteus spp., and Bacteroides spp. In our hospital, the incidence of pressure ulcers has declined in recent years, coinciding with the implementation of a multidisciplinary team aimed at preventing and treating chronic ulcers. Mortality rate is high, and hospital-acquired bacteremia, polymicrobial bacteremia, and serum albumin < 23 g/L are associated with increased mortality.