Risk Factors Associated with Pressure Ulcer Recurrence after Reconstruction: Analysis of a National Database.

In this study we sought to clarify the patient traits and comorbidities that are associated with pressure injury recurrence following pressure injury reconstruction. An insurance claims database, PearlDiver, was used to conduct a retrospective cohort study. The two cohorts included patients who underwent pressure injury reconstruction without recurrence and patients who experienced recurrence with subsequent reconstruction. Multiple logistic regression analysis was used to identify risk factors for recurrence after reconstruction. Recurrence was associated with hypoalbuminemia (p<0.05), paraplegia (p<0.05), and osteomyelitis (p<0.05). In patients with osteomyelitis, primary closure was associated with recurrence (p<0.05) while flap reconstruction was not (p>0.05). Osteomyelitis was not associated with recurrence after flap reconstruction. Prior to reconstruction, patients with osteomyelitis and hypoalbuminemia should have their nutrition and infection optimized.