Background and aims: Sacral ulcers (SUs) or pressure sores on the lower back and spine areas are a health risk with extended periods of bed confinement and prolonged immobility, as would be the case with rehabilitation hospitalization. Rehabilitation hospitals aim to provide treatment care for their recovery of functional abilities following illness or injury. Sacral ulcer risk outcomes vary among rehabilitation hospital older adults patients. We hypothesize that sacral ulcer risk outcomes with rehabilitation hospitalization would vary by their age, comorbid health conditions and length of stay in hospital. Methods: Utilizing a retrospective cohort analysis, we sampled 1,290 patients aged 60+ with SUs and 37,626 patients without SUs from the Texas Inpatient Public Use Data File. The data analysis included Binary logistic regression for moderation and mediation effects on SU outcomes. For the moderation effects by age cohort, the 60-69 years old was the reference group and by 10 year age incremental up to 90+ years. The mediation analysis employed weighted comorbidity index scores and length of hospital admission. Results: As would be expected, hospital admission significantly increased SU risk (AOR = 2.13, 95% CI: 1.85-2.42), and with longer length of stay. Surprisingly, comorbidities had a minimal effect on SU risk while patients aged 80+ had a lower SU risk than those aged 60-69.
Conclusion and implications: Admission for hospital stay singularly presents high risk for SUs regardless of older adult patient characteristics. Rehabilitation hospitals should address care practices for minimizing SU risk for older adult, and particularly with extended stay. Such targeted care plans would minimize SU risks by the vulnerabilities of older age and comorbidities.