Why can a pressure ulcer be life threatening?
ARTICLE WRITTEN BY SYLVIE HAMPTON
Death from a pressure ulcer can be through septicaemia, osteomyelitis or from the toxins created by the bacteria.
If toxins are produced, it can lead to a large drop in blood pressure, known as septic shock causing damage to multiple organs, which can be fatal. Pathologists used to write ‘Kidney Failure’ on death certificates. Now they write ‘Kidney failure secondary to pressure ulcers’. Then it is likely to go to Coroner’s Court and the carers will need to justify any decisions they made and the person’s death may well be found to be negligence if the justification is not made.
In osteomyelitis the cartilage, tissue and bone can be damaged with the potential to affect the joints and limbs.
In 2013, there were 29,000 documented deaths globally, up from 14,000 deaths in 1990 (Naghavi, 2013) related to pressure ulcers. Osteomyelitis affects up to 32% of full-thickness pressure ulcers and increases treatment costs and the risk of systemic complications (Rennert et al. 2009)
In 2010, more than 27,000 people died with bedsores or infected wounds (Daily Telegraph 29 Jan 2012) and 7-8% of those who develop pressure ulcers will die from related complications (e.g., sepsis, osteomyelitis) (Richards et al., 2004).
Nearly 80% of pressure ulcer-associated deaths occurred in persons at least 75 years old and septicaemia was reported in 39.7% of pressure ulcer-associated deaths (Redelings et al. 2005).
It should be noted here that a Kennedy Terminal Ulcer is almost impossible to prevent. This is part of the dying process and the skin is failing. Nurses should be aware of this particular pressure ulcer. (See SCALE - Skin Changes At Life’s End which can be downloaded here.