ORIGINAL RESEARCH article
Front. Med.
Sec. Geriatric Medicine
This article is part of the Research TopicChallenges and Innovations in Healthcare Management and Long-Term Care for an Aging SocietyView all 35 articles
Clinical and Systemic Factors Associated with Pressure Ulcer Development: A Retrospective Evaluation of 339 Patients in a Palliative Care Unit
Provisionally accepted
Fatih Oner Kaya*
Selçuk Şimşek- Maltepe Universitesi Tip Fakultesi, Maltepe, Türkiye
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Background: Pressure ulcers (PUs) remain a prevalent and serious complication in palliative care settings, often resulting from a combination of immobility, systemic illness, and inadequate preventive strategies. Understanding the multifactorial risk landscape is essential for developing effective interventions. Objective: This study aimed to determine the prevalence of pressure ulcers and to identify clinical and systemic risk factors associated with PU development in a palliative care population. Methods: A retrospective, single-center study was conducted by reviewing medical records of 339 adult patients hospitalized for more than 24 hours in the palliative care unit of Maltepe University Hospital between June 2021 and November 2023. Demographic data, comorbidities, Braden and Care Dependency Scale (CDS) scores, and PU characteristics were analyzed. Multivariable logistic regression was used to identify independent risk and protective factors. Results: The overall prevalence of pressure ulcers was 33.6%. A total of 385 ulcers were recorded among 114 patients, with deep tissue injury (26%) being the most common type. Significant independent risk factors included stroke (OR: 4.89), gastrointestinal diseases (OR: 8.72), paraplegia (OR: 17.65), recent confusion (OR: 148.00), hypertension (OR: 2.98), coronary artery disease (OR: 3.42), arrhythmia (OR: 3.05), and heart failure (OR: 3.88). Longer hospital stay also increased PU risk (OR: 1.04 per day). In contrast, adherence to PU prevention protocols (OR: 0.18) and complete care dependency (OR: 0.02) were significant protective factors. Conclusion: Pressure ulcers are alarmingly common in palliative care patients and are closely linked to multiple comorbid conditions. Targeted preventive measures focusing on cardiovascular and neurological stability, nutritional support, cognitive function, and strict adherence to care protocols are vital. Proactive, multidisciplinary management and individualized risk assessment should be integrated into routine care to reduce PU burden and improve patient outcomes.
Keywords: Pressure Ulcer, Palliative Care, cardiovascular disease, Stroke, Braden scale, care dependency, Risk factors, Retrospective study
Received: 15 Aug 2025; Accepted: 17 Nov 2025.
Copyright: © 2025 Kaya and Şimşek. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Fatih Oner Kaya, fatihonerkaya1@gmail.com
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