Prevalence of pressure injuries in Japanese older people: A population-based cross-sectional study

Objectives: The prevalence of pressure injuries is an essential indicator of prevention and quality of care. Population-based prevalence data on pressure injuries are scarce in Japan. This study aimed to estimate the prevalence of pressure injuries per 1000 adults and per 1000 older people in Japan. Design: Cross-sectional survey. Setting: This study was conducted in Goto, a city located on a remote rural archipelago in Japan. In 2017, the population was 37,855; older people aged ≥65 years accounted for 37.7%. Participants: Participants were enrolled in various facilities in the city. In total, 1126 participants (median age 85 years) were assessed to calculate age-specific numbers of people with pressure injuries. Measurements: Participants were directly evaluated by the research team between August and September 2017, and pressure injuries were classified using DESIGN-R schema. We calculated the number of adults with pressure injuries in Goto based on the proportion of pressure injuries in specific age categories. In these prevalence estimations, we assumed that all cases aged ≥65 years were long-term care insurance-certified older people, and all cases aged 18–64 years were people with physical disabilities who received social welfare services. Results: Of the 1126 participants, 113 (10%) had one or more pressure injuries. Overall, the estimated number of adults with pressure injuries in Goto was 301.4. The prevalence rate of pressure injuries was 9.2 per 1000 population in adults aged ≥18 years (95% confidence interval [CI] 8.1–10.2), 20.3 in those aged ≥65 years (95% CI 18.1–22.7), and 44.6 in those aged ≥80 years (95% CI 39.5–50.2). Conclusions: This study revealed a high population-based prevalence of pressure injuries in a rural Japanese community. A key reason for this high disease burden in Japan appears to be the susceptibility of the aged population to pressure injuries.