Pressure ulcers, also known as bedsores or pressure injuries, represent a significant health concern that affects millions of people globally. These localized injuries to the skin and underlying tissue typically develop from prolonged pressure or friction. Quantifying the scale of this problem through current statistics reveals a burden on patients and healthcare systems that is far greater than generally recognized.
Overall Incidence and Prevalence Rates
Pressure ulcers are a major public health challenge worldwide. In the United States alone, approximately 2.5 to 3 million adults are estimated to develop pressure injuries each year, highlighting the widespread nature of the condition across all care environments.
Prevalence rates in American hospitals have been reported to range widely, often falling between 12% and 25.1% of all hospitalized patients. Globally, the pooled estimate for the incidence of new pressure ulcer cases across different hospital wards is approximately 12%. The majority of these injuries are classified as Stage 1 or Stage 2, but even these earlier stages require significant preventative and treatment resources.
Statistical Breakdown by Care Setting
The likelihood of developing a pressure ulcer is heavily influenced by the specific healthcare environment. Long-term care facilities, such as nursing homes, often report some of the highest prevalence rates, ranging from roughly 2.2% to 32% in various studies. This increased prevalence is statistically linked to the patient population, which typically consists of individuals with higher levels of frailty, reduced mobility, and chronic underlying conditions.
Acute care hospitals focus on the rate of hospital-acquired pressure injuries (HAPIs), which are those that develop after admission. HAPI rates in acute settings have been documented to be around 4.5%, although the overall prevalence of pressure ulcers (including those present on admission) can be much higher. The intensive care unit (ICU) is a particularly high-risk area within the hospital, with reported prevalence rates ranging from 5% to 30%, driven by factors like prolonged immobility, hemodynamic instability, and the use of vasopressors.
Patients receiving care in community or home health settings generally show lower rates, with prevalence estimates typically falling between 0% and 17%. The variation in rates across settings underscores that risk management must be tailored to the specific environment and the unique vulnerabilities of its patient population.
Economic and Health Impact Metrics
The financial consequences of pressure ulcers are substantial for healthcare systems. In the United States, the annual expenditure for treating pressure ulcers is estimated to be between $9.1 billion and $11.6 billion, with some models suggesting the cost for hospital-acquired injuries alone may exceed $26.8 billion. The average incremental cost of treating a single hospital-acquired pressure injury can be around $21,767 per patient.
Treatment costs for an individual pressure ulcer are high, ranging from $20,900 to $151,700 depending on the severity and complications. These injuries also significantly increase the duration of hospitalization, with the average length of stay for a patient with a pressure ulcer being three times longer than the average stay for other conditions. Furthermore, pressure ulcers are associated with over 17,000 lawsuits annually.
The health outcomes associated with pressure ulcers increase both morbidity and mortality. Approximately 60,000 patients die each year as a result of complications. A patient who develops a pressure ulcer faces a two to six times greater risk of mortality compared to a patient with intact skin. Hospital-acquired pressure injuries are also linked to poor post-discharge outcomes, with patients having a 1.5 to 2 times greater risk of readmission within 30, 60, or 90 days after discharge.