RESUMO
Decubital lesions indicate the gravity of the pathologies of the elderly patients, representing a serious cause of disability and of mortality. The present study was aimed at evaluating the decubital lesions during 1 year of treatment in an assisted sanitary residence (abbreviated as RSA from the Italian name), through observations of the assistential and therapeutical outcomes, aimed at improving the quality of life of the recovered elderly patients. We had 131 patients involved from a total of 308 recovered patients in the RSA. Their mean age was 83.4+/-1.3 years (74 women and 57 men). All cases were treated, considering the actual clinical stages, according to the advanced protocols on the basis of the guidelines of the National Pressure Ulcer Advisory Panel (NPUAP). All patients were evaluated by using the Braden-scale at the start and after 30 days for having a risk for the development of decubital ulcers and also for monitoring the modifications during the therapy, while the improvements were evaluated only clinically, establishing the reduction of the stage of the lesions. A precise analysis of the data revealed a higher prevalence of decubital lesions at the entrance to the RSA, particularly the advanced Grades III and IV (84 patients, 27% of all recovered subjects), compared to those with lower gravity Grades I and II (47 cases, 15% of all recovered subjects). Complete healing was observed only in a few cases (18.0%), mainly in the lower grades. Applying the therapeutic methods and protocols of NPUAP, most of the ulcers displayed an improving tendency. We had only a few mortal cases due to the ulcers (3 deaths of 131 patients), nevertheless, numerous death cases for other causes occurred among the patients, having advanced grades of ulcers (12%). Our data confirm the statement that the decubital ulcers represent the marker of severity of the polypathological state of the fragile elderly patients.
