The Significance of the Relationship between the Degree of Bony Prominences and Pressure Ulcer Development in Elderly Patients

Abstract

　To obtain efficient methods for the prediction of pressure ulcer development in elderly patients, we evaluated the factors that influences the development of pressure ulcer, especially the degree of bony prominence under the sacral region in nursing home patients, aged between 66 to 96. The degree of bony prominence was calculated with two indexes, maximum interface pressure and total interface pressure of the sacral region.
　The development of pressure ulcers significantly correlated with degree of bony prominence. The degree of bony prominence was predicted by the obesity and activity index used in the Braden scale, not by posture and contracture of patients. Using these indexes, we were able the pressure ulcer development with 86% sensitivity, 66% specificity.
　Our results suggested that measurement of total interface pressure is necessary for estimating the degree of bony prominence. This index was influenced by the nutrition state and atrophy of the muscular tissue in the sacral region due to low physical activity. Furthermore, this research demonstrated that the assessment of degree of bony prominence could be a useful clinical method for prediction of pressure ulcer development.