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Background <p>Pressure ulcers remain among the most common care-related complications in vulnerable patient populations. The COVID-19 pandemic challenged healthcare systems globally, and its consequences can be retrospectively assessed through legal medicine.</p> Objective <p>This study aimed to analyze the prevalence, severity and characteristics of advanced pressure ulcers (stage&#xa0;III/IV) in deceased individuals in Hamburg over a&#xa0;6-year period (2018–2023), with a&#xa0;focus on potential changes during the pandemic.</p> Materials and methods <p>A&#xa0;retrospective cross-sectional study was conducted using data from external post-mortem and cremation examinations documenting stage&#xa0;III or IV pressure ulcers. Collected variables included age, sex, body mass index (BMI), ulcer localization and condition, dressing quality, comorbidities, place of death, and pandemic phase. Statistical analyses were performed using Chi-squared test, Mann–Whitney U&#xa0;test, and logistic and linear regression models.</p> Results <p>Among 61,964 examined deceased individuals, 406 cases with 527 stage&#xa0;III or IV pressure ulcers were identified. The prevalence increased from 0.50% in the prepandemic phase (2018/2019) to 0.77% during the pandemic (2020/2021) and remained elevated at 0.69% postpandemically (2022/2023). While total case numbers rose, the proportion of stage&#xa0;IV ulcers declined, accompanied by an increase in stage&#xa0;III lesions. A&#xa0;shift towards atypical anatomical ulcer locations (heel, trochanter) was observed. Higher age, BMI, and multimorbidity were associated with ulcer occurrence.</p> Conclusion <p>Forensically collected data provide meaningful insights into care quality during crisis conditions. The systematic documentation of advanced pressure ulcers at postmortem examinations can serve as a&#xa0;retrospective tool to monitor and identify structural care deficits.</p>

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Dekubitusprävalenz und -versorgung im rechtsmedizinischen Kontext: eine retrospektive Analyse im Verlauf der COVID-19-Pandemie

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月26日

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  • Antonia Fitzek,
  • Benjamin Ondruschka,
  • Alexandra Ron

摘要

Background

Pressure ulcers remain among the most common care-related complications in vulnerable patient populations. The COVID-19 pandemic challenged healthcare systems globally, and its consequences can be retrospectively assessed through legal medicine.

Objective

This study aimed to analyze the prevalence, severity and characteristics of advanced pressure ulcers (stage III/IV) in deceased individuals in Hamburg over a 6-year period (2018–2023), with a focus on potential changes during the pandemic.

Materials and methods

A retrospective cross-sectional study was conducted using data from external post-mortem and cremation examinations documenting stage III or IV pressure ulcers. Collected variables included age, sex, body mass index (BMI), ulcer localization and condition, dressing quality, comorbidities, place of death, and pandemic phase. Statistical analyses were performed using Chi-squared test, Mann–Whitney U test, and logistic and linear regression models.

Results

Among 61,964 examined deceased individuals, 406 cases with 527 stage III or IV pressure ulcers were identified. The prevalence increased from 0.50% in the prepandemic phase (2018/2019) to 0.77% during the pandemic (2020/2021) and remained elevated at 0.69% postpandemically (2022/2023). While total case numbers rose, the proportion of stage IV ulcers declined, accompanied by an increase in stage III lesions. A shift towards atypical anatomical ulcer locations (heel, trochanter) was observed. Higher age, BMI, and multimorbidity were associated with ulcer occurrence.

Conclusion

Forensically collected data provide meaningful insights into care quality during crisis conditions. The systematic documentation of advanced pressure ulcers at postmortem examinations can serve as a retrospective tool to monitor and identify structural care deficits.