Abstract Rationale Sepsis is a life-threatening condition associated with significant morbidity and mortality. Decubitus ulcers (pressure injuries) are common in hospitalized patients and may become a source of infection. This study seeks to investigate the association between the presence of decubitus ulcers and inpatient outcomes, including mortality, resource utilization, and complications. Among patients hospitalized with sepsis in the United States, as large-scale data on this association is limited. Methods This retrospective cohort study utilized the Nationwide Inpatient Sample (NIS) database from 2016 to 2021. Patients hospitalized with a primary diagnosis of sepsis were identified and stratified based on the presence or absence of a concurrent diagnosis of decubitus ulcer. Multivariable logistic regression was used to assess the odds of in-hospital mortality and specific complications (severe sepsis, septic shock, DIC, ARDS, mechanical ventilation, AKI). Multivariable linear regression was used to compare total hospital charges, costs, and length of stay (LOS). Models were adjusted for patient demographics (age, gender, race, income quartile, and insurance), the Charlson Comorbidity Index, patient residence location, and hospital characteristics (region, bed size, and teaching status). Results Of approximately 13. 1 million weighted sepsis admissions, 1, 046, 110 (8. 0%) had comorbid decubitus ulcers (2016-2021). Patients with decubitus ulcers were slightly older (mean age 64. 5 vs. 69. 3 years, p. 01) and had higher comorbidity burdens. After multivariable adjustment, the presence of a decubitus ulcer was significantly associated with 35% increased odds of in-hospital mortality (1. 35, p. 01). Decubitus ulcers were also associated with significantly higher adjusted total hospital charges (40, 776. 83, p. 01), total costs (coefficient 8, 175. 51, p. 01), and longer LOS (coefficient 3. 85 days, p. 01). Furthermore, decubitus ulcers were associated with significantly higher adjusted odds of developing severe sepsis (AOR 1. 35), septic shock (AOR 1. 58), DIC (AOR 1. 18), requiring mechanical ventilation (AOR 3. 99), and AKI (AOR 1. 05) (all p. 01). No significant association was found with ARDS (AOR 1. 04, p = 0. 068). Conclusion The study suggests the presence of a decubitus ulcer was independently associated with significantly increased inpatient mortality, higher resource utilization (cost, LOS), and greater odds of major sepsis-related complications. These findings highlight decubitus ulcers as an important indicator of adverse outcomes in patients with sepsis, emphasizing the need for targeted prevention and management strategies in this vulnerable population. This abstract is funded by: None
Akella et al. (Fri,) studied this question.