Most cited article - PubMed ID 35725785
How the COVID-19 pandemic influences the prevalence of pressure injuries in the Czech Republic: A nationwide analysis of a health registry in 2020
Pressure ulcers (PUs) impose a significant economic burden on healthcare systems, affecting patient quality of life and leading to substantial treatment costs. This study presents a cost-of-illness analysis of PU treatment in hospitalized patients in the Czech Republic, based on real-world clinical data. The analysis was conducted using a comprehensive methodology at a Czech university hospital, involving 304 hospitalizations. The study included all hospitalized patients with PUs. Data were collected employing a bottom-up, person-based approach, which refers to the collection and analysis of cost data at the individual patient level. This method captures detailed resource utilization for each patient. The methodology accounted for both systemic and local costs, including materials, medications, caregiver time, and procedures. The study involved 304 hospitalizations, with a mean length of stay of 13 days. The total cost of PU treatment, excluding pharmacotherapy, had a median of €678, while including pharmacotherapy, the median cost rose to €929. Younger patients incurred higher treatment costs. Significant cost variations were observed among different departments. We developed and applied a novel cost model to quantify the expenses associated with PUs, which accurately highlighted the financial burden in the hospital care setting. We present a rigorous methodology for PU cost-of-illness analysis, providing a valuable tool for future research and clinical practice. This comprehensive approach supports the development of targeted interventions to reduce the incidence and severity of PUs, ultimately improving patient care and reducing healthcare costs.
- Keywords
- cost analysis, healthcare costs, patients, pressure ulcers, treatment costs,
- MeSH
- Pressure Ulcer * economics therapy MeSH
- Length of Stay economics MeSH
- Adult MeSH
- Hospitalization * economics MeSH
- Middle Aged MeSH
- Humans MeSH
- Health Care Costs * statistics & numerical data MeSH
- Hospitals, University economics MeSH
- Cost of Illness * MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- Czech Republic MeSH
Pressure ulcers (PUs), also known as pressure injuries, are chronic wounds that represent potential lifelong complications. Pressure ulcers of a deep category (III and IV) are often indicated for surgical treatment - debridement and surgical reconstruction. Sharp surgical debridement is widely used in the debridement of PUs; however, the Versajet® hydrosurgery system is becoming an increasingly popular tool for tangential excision in surgery due to its numerous advantages. This work focused on the expression of selected genes, especially those associated with oxidative stress, in PUs debrided by two approaches - sharp surgical debridement and debridement using Versajet® hydrosurgery system. Expression of following genes was evaluated: NFE2L2, ACTA2, NFKB1, VEGFA, MKI67, HMOX1, HMOX2, HIF1A, and SOD2. ACTB and PSMB were used as housekeeping genes. So far, five patients have been enrolled in the study. Preliminary results suggest no significant difference in gene expression with different pressure ulcer treatment approaches except NFE2L2, despite the macroscopic differences. However, the results revealed correlations between the expression of some genes, namely HIF1A and SOD2, VEGFA and SOD2 and VEGFA and HIF1A. These results may indicate a connection between hypoxia, oxidative stress, pressure ulcer healing processes and angiogenesis.
- MeSH
- Debridement methods MeSH
- Pressure Ulcer * genetics surgery MeSH
- Gene Expression MeSH
- Suppuration MeSH
- Wound Healing * genetics MeSH
- Humans MeSH
- Pilot Projects MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH