| S CIE |
| Shilpa Krishnan , Ickpyo Hong , Grace Couture , Yi-Ting Tzen , Timothy Reistetter |
| Journal of the American Medical Directors Association Vol.23(10), 2022 |
| https://doi.org/10.1016/j.jamda.2022.06.025 |
| Objective: To describe pressure injury (PrI) prevalence, comorbidities, and rehabilitation utilization
among older adults with stroke at skilled nursing facilities’ (SNFs’) admission assessment.
Design: Retrospective cohort.
Setting and Participants: Older Medicare beneficiaries (>65 years old) with stroke admitted to SNFs. Methods: We extracted data between 2013 and 2014 using the Master Beneficiary Summary, Medicare
Provider Analysis and Review, and Minimum Data Set 3.0. PI data were assessed during admission
assessment. Results: Of the 65,330 older adults poststroke admitted to SNFs, 11% had at least 1 PrI present on
admission assessment. Individuals who were non-Hispanic Black, with a longer hospital stay, from lower
socioeconomic status, with higher proportions of comorbidities (eg, underweight, urinary and bowel
incontinence, diabetes, congestive heart failure, arrhythmias, and infections), and higher functional
impairments were likely to present with a PrI at SNF admission assessment. Compared with individuals
with superficial PrI, individuals with deep PrI were more likely to be young-old (<75 years), non
Hispanic Black, from lower socioeconomic status, present with a shorter hospital stay, an intensive
care unit stay, with higher functional impairments, skin integrity issues, s ystem failure, and infections.
Compared to those without PrI or superficial PrI, individuals with any-stage PrI or deep PrI were more
likely to be cotreated by physical and occupational therapist and less likely to receive individual therapy.
Those with PrI poststroke had low documented turning and repositioning rates than those without PrI.
Conclusions and Implications: Identifying modifiable risk factors to prevent PrIs poststroke in SNFs will
facilitate targeted preventative interventions and improve wound care efficacy and rehabilitation utili
zation for optimized patient outcomes. Identifying residents with a higher risk of PrI during acute care
discharge and providing early preventive care during post-acute care would possibly decrease costs and
improve outcome quality. |