Background
Pressure injuries contribute substantially to patient morbidity and healthcare costs. However, comprehensive analyses of their burden within the U.S. paediatric population are limited. As a cross-sectional database, the National Inpatient Sample permits estimation of hospitalization-based prevalence rather than true prevalence. We hypothesized that pressure injury burden would increase over time with significant sociodemographic variations.
Methods
This cross-sectional study used the National Inpatient Sample (2010-2019) to analyse temporal trends in the hospitalization-based prevalence, length of stay, and total inpatient costs for paediatric patients (1–17 years) with a diagnosis of pressure injury. Trends were analysed using Joinpoint regression, and differences across sociodemographic subgroups were examined.
Results
Among 2640,461 weighted paediatric admissions, 32,905 cases involved a pressure injury diagnosis. The annual prevalence increased significantly from 0.20% in 2010 to 0.31% in 2019 (annual percentage change = 6.1%; 95% confidence interval 4.6%-7.7%). Mean length of stay significantly increased from 16.42 to 19.25 days (average annual percentage change = 1.54%, 95% confidence interval 0.03%-3.07%). Mean total hospitalization costs (inflation-adjusted to 2019 U.S. dollars) for patients with pressure injury diagnoses rose substantially from $137,609 to $309,776. Variations were observed across sociodemographic groups.
Conclusion
The increasing prevalence, length of stay, and total hospitalization costs among hospitalized U.S. paediatric patients aged 1-17 years with pressure injury diagnoses highlight a growing clinical and economic challenge. The observed differences across age, race, and socioeconomic groups warrant further investigation to inform future surveillance and research. Because the National Inpatient Sample does not distinguish hospital-acquired from community-acquired pressure injuries and does not isolate pressure injury-attributable costs from total hospitalization costs, causal inferences and direct policy recommendations require caution.