BACKGROUND: Malnutrition is common in elderly and is a risk factor for pressure ulcers.AIM: The aim of the present study was to determine the prevalence of malnutrition in geriatric and palliative patients hospitalised in long-term care facility, and to examine the influence of nutritional status on the prevalence of pressure ulcers (PU).MATERIAL AND METHODS: Descriptive, observational and cross-sectional study including 2099 patients admitted to the Hospital during a 24 month period (January 2013 to December 2014). We recorded: demographic data, body mass index (BMI), Braden score, laboratory parameters of interest (albumin, total protein, RBC count, haemoglobin and iron levels) and presence or absence of malnutrition and pressure ulcers.RESULTS: The pressure ulcer prevalence was 12.9% (256 out of 2099). Based on the BMI classification, 61.7% of patients had a good nutritional status, 27.4% were undernourished, and 2.1% were considered malnourished. Nutritional status was statistically significantly different between patients with and without PU (p < 0.0001). This study also showed that hypoproteinemia, hypoalbuminemia, low RBC was positively associated with PU prevalence.CONCLUSION: The results highlight the impact of nutritional status on the prevalence of pressure ulcers in hospitalised geriatric and palliative population. It is of paramount importance to correctly evaluate the presence of malnutrition in patients at risk of pressure ulcers.

Background: In elderly patients with hypoalbuminaemia, hypoproteinaemia and advanced-stage PUs, chronic inflammation and wound-related protein loss contribute to a self-perpetuating circulus vitiosus, in which protein depletion drives deterioration of tissue repair processes, and in turn, ongoing wound-related catabolism further amplifies systemic protein loss. In this context, reduced serum albumin and total protein represent integrated indicators of systemic inflammatory and catabolic burden associated with delayed wound healing. Aim: This study evaluated the association between individualized nutritional replacement therapy and pressure ulcer healing in malnourished geriatric and palliative patients, using serum albumin, total protein, and PUSH score as longitudinal outcome indicators. Methods: A total of 78 malnourished geriatric and palliative patients with PUs, multiple comorbidities, and poor nutritional status (hypoalbuminemia and/or hypoproteinaemia) receiving patient-tailored nutritional replacement therapy participated in this study. PU assessment using the PUSH version 3.0 tool, as well as measurements of serum albumin and total protein concentrations, were performed on days 0, 30, 60, and 90. Results: Our study demonstrates significant improvement in the serum albumin levels, from 30.2 ± 6.19 at baseline to 42.1 ± 5.59 at day 90. Similarly, total protein concentrations increased from 57.8 ± 9.66 at baseline to 70.6 ± 7.03 at day 90. The improvement in protein status was accompanied by a significant reduction in the PUSH score, from 10.9 ± 2.94 at the first assessment to 2.9 ± 2.63 at the final assessment. Spearman’s rank-order correlation analysis between serum albumin, total protein, and PUSH score demonstrated a significant moderate inverse correlation at later assessment points (day 60 and 90). Conclusions: Individualized and targeted replacement therapy was associated with improved protein status and reduced pressure ulcer severity. Increases in serum albumin and total protein paralleled a marked reduction in PUSH scores, suggesting attenuation of the inflammatory-catabolic circulus vitiosus and a progressive shift toward wound healing in geriatric and palliative patients.