Association of Anemia with Pressure Ulcers, Falls, and Hospital Admissions among Long-term Care Residents

Purpose

To evaluate the association between anemia and the clinical endpoints of pressure ulcers, falls, and hospital admissions in long-term care residents.

Methods

Data were derived retrospectively from the AnalytiCare (Glenview, IL) proprietary database, containing laboratory data and detailed resident health status and condition indicators available in the Minimum Data Set (MDS) reports for 27 long-term care facilities in Colorado during January 1, 2007-September 15, 2008. Eligible residents had >90 days in the facility and a hemoglobin (Hb) value within 90 days of the earliest nonadmission (index) MDS. Anemia was defined as Hb <12 g/dL female, <13 g/dL males. Pressure ulcers were identified from the index MDS. Falls and hospital admissions were identified from all postindex MDS assessments. Logistic regression, adjusted for other covariates, was used to analyze the relationship between anemia and Hb level with the rate of pressure ulcers, falls, and hospital admissions.

Results

There were 838 residents who met inclusion criteria. Mean age was 78 years, 67% were female. Nine percent had pressure ulcers. Pressure ulcers increased from a rate of 6% for residents with Hb levels ≥13 g/dL to 21% for those with Hb <10 (P <.001). In the logistic regression model, anemia was associated with an odds ratio of 2.23 for pressure ulcers (95% confidence interval, 1.32-3.78, P = .003). Having anemia was associated with a 58% higher odds of falls (P = .012) and 134% higher odds of hospital admissions (P <.001). Risk of falling and hospital admissions centered on those having Hb levels from 10 to <12 g/dL.

Conclusion

Consistent with previous research and subject to study design limitations, anemia in the residents studied was associated with statistically significant higher odds of pressure ulcers, falls, and hospital admissions.