Pressure ulcers, also called pressure injuries in the cited literature, are measured differently across hospitals, nursing homes and administrative systems. The figures below distinguish prevalence, incidence, hospital-acquired rates, service use, costs and mortality by population, period and geography.
Key Pressure Ulcer Statistics
The most broadly useful figures are:
- In global studies published from 2008–2018, 12.8% of hospitalized adults had a pressure injury, based on a pooled estimate from studies of hospitalized adults worldwide.
- In global hospital studies published from 2008–2018, hospital pressure-injury incidence was 5.4 per 10,000 patient-days.
- In the same global evidence base, 8.4% of hospitalized patients had a hospital-acquired pressure injury, although definitions varied between studies.
- The hospital prevalence estimate from studies published from 2008–2018 represented 1,366,848 patients worldwide in the contributing studies.
- The hospital incidence estimate from studies published from 2008–2018 represented 681,885 patients worldwide in the contributing studies.
- The hospital-acquired-rate estimate from studies published from 2008–2018 represented 1,893,593 patients worldwide in the contributing studies.
- Among nursing-home residents aged 60 and older, 11.6% had an any-stage pressure injury in data collected after 2000 and synthesized in a 2023 review.
- Among nursing-home residents aged 60 and older, 7.2% had a pressure injury when stage I was excluded in the same review.
- The pooled any-stage pressure-injury incidence among nursing-home residents aged 60 and older was 14.3% in data collected after 2000.
- The pooled nursing-home-acquired pressure-injury rate among residents aged 60 and older was 8.5% in data collected after 2000.
- In U.S. nursing homes in 2004, about 159,000 of 1.5 million residents had a pressure ulcer, producing an overall prevalence of 11%.
- In the 2004 U.S. nursing-home survey, stage 2 pressure ulcers affected 5% of residents and represented about half of all pressure ulcers.
- In U.S. nursing homes in 2004, residents with recent weight loss had 20% prevalence, compared with 10% among residents without recent weight loss.
- In U.S. nursing homes in 2004, residents with high immobility had 16% prevalence, compared with 5% among residents without high immobility.
- In U.S. nursing homes in 2004, residents with recent bowel or bladder incontinence had 12% prevalence, compared with 7% among continent residents.
- Among U.S. nursing-home residents with stage 2 or higher ulcers in 2004, 35% received special wound care.
- AHRQ estimated the additional cost of a hospital-acquired pressure ulcer at $14,506 per case in 2016 U.S. dollars, with substantial uncertainty.
- AHRQ estimated 0.041 excess deaths per hospital-acquired pressure-ulcer case, or 41 excess deaths per 1,000 cases, using evidence reviewed for its 2017 report.
- Italy’s adapted hospital-acquired pressure-ulcer rate was 21.1 per 10,000 eligible discharges in 2018 and 17.2 in 2019.
- Italy’s crude hospital-acquired pressure-ulcer rate was 14.6 per 10,000 eligible discharges in 2023, after rates of 13.3 in 2020, 13.2 in 2021 and 13.9 in 2022.
Contents
- Hospital prevalence and incidence
- Nursing-home prevalence, stages and locations
- U.S. nursing-home differences by resident characteristics
- Weight loss, immobility, incontinence and wound care
- Hospital-acquired costs and mortality
- Italy’s hospital-acquired pressure-ulcer trends
Hospital Pressure Ulcer Prevalence and Incidence
A 2020 systematic review and meta-analysis combined studies of hospitalized adults published from 2008–2018. Its pooled prevalence is a proportion measured at a specified point, while incidence uses patient-days as the denominator; neither should be read as a count of unique people in a national population.
| Hospital measure | Estimate | Population and period |
|---|---|---|
| Pressure-injury prevalence | 12.8% (95% CI 11.8%–13.9%) | Hospitalized adults worldwide; studies published 2008–2018 |
| Pressure-injury incidence | 5.4 per 10,000 patient-days (95% CI 3.4–7.8) | Hospitalized adults worldwide; studies published 2008–2018 |
| Hospital-acquired rate | 8.4% (95% CI 7.6%–9.3%) | Hospitalized adults worldwide; studies published 2008–2018 |
The pooled prevalence evidence represented 1,366,848 patients, the incidence evidence represented 681,885 patients, and the hospital-acquired-rate evidence represented 1,893,593 patients. These are evidence-base sizes rather than population censuses or numbers of incident cases.
The review used random-effects pooled estimates across heterogeneous observational studies. Hospital-acquired definitions and surveillance varied between studies, so the three measures describe related but non-interchangeable outcomes.
Nursing-Home Pressure Ulcer Prevalence, Incidence and Locations
A 2023 systematic review examined pressure injuries among nursing-home residents aged 60 and older, using data collected after 2000. The review included 47 studies after screening 3,384 abstracts, but the number of contributing studies differed by outcome.
| Nursing-home measure | Pooled estimate | Scope |
|---|---|---|
| Any-stage prevalence | 11.6% (95% CI 9.6%–13.7%) | Residents aged 60+; data collected after 2000 |
| Prevalence excluding stage I | 7.2% (95% CI 6.2%–8.3%) | Residents aged 60+; data collected after 2000 |
| Any-stage incidence | 14.3% (95% CI 5.5%–26.2%) | Residents aged 60+; four studies |
| Nursing-home-acquired rate | 8.5% (95% CI 4.4%–13.5%) | Residents aged 60+; six studies |
The any-stage and stage-I-excluded estimates are not directly comparable because they use different case definitions. The incidence estimate has a wide confidence interval because only four studies contributed, while acquisition definitions varied across the six studies contributing to that rate.
The review also reported the distribution of pressure-injury locations. The heel accounted for 34.1% of reported locations, the sacrum for 27.2%, and the foot for 18.4%.
These are shares of reported locations, not resident prevalence; multiple locations may be counted within cases.
U.S. Nursing-Home Pressure Ulcer Data by Resident Characteristics
The CDC’s National Nursing Home Survey provides a historical U.S. snapshot from 2004. It estimated that about 159,000 of 1.5 million current nursing-home residents had a pressure ulcer, equivalent to 11% prevalence at the interview point.
| Resident or ulcer category | 2004 U.S. prevalence |
|---|---|
| Stage 1 | 3% of residents |
| Stage 2 | 5% of residents; about half of all ulcers |
| Stage 3 | 1% of residents |
| Stage 4 | 2% of residents |
| Age 64 and under | 14% |
| Older than 64 | 10% |
| Male residents | 13% |
| Female residents | 10% |
| Staying one year or less | 16% |
| Staying longer than one year | 7% |
Source: Pressure Ulcers Among Nursing Home Residents: United States, 2004.
The survey also reported 10% prevalence among White residents and 11% among nonwhite residents, with no significant difference reported. The historical categories and cross-sectional design limit interpretation, and these figures should not be presented as current U.S. prevalence.
Length of stay was associated with prevalence: residents staying one year or less had 16%, compared with 7% among those staying longer than one year. This association may reflect admission risk and survivor effects rather than a causal effect of residence duration.
Pressure Ulcer Risk Factors and Wound-Care Statistics
The 2004 U.S. nursing-home survey also compared prevalence with clinical and functional characteristics. These are observed associations, not proof that any single characteristic caused a pressure ulcer.
- Residents with recent weight loss had 20% prevalence, compared with 10% among residents without recent weight loss.
- Residents with high immobility had 16% prevalence, compared with 5% among residents without high immobility.
- Residents taking more than eight medications had 13% prevalence, compared with 9% among residents taking eight or fewer.
- Residents with recent bowel or bladder incontinence had 12% prevalence, compared with 7% among continent residents.
Among residents with stage 2 or higher ulcers, 35% received special wound care. By reported stage, special wound care was provided to 33% of stage 2 residents, 37% of stage 3 residents and 40% of stage 4 residents.
The same survey reported that 65% of residents with stage 2 or higher ulcers did not receive special wound care. The corresponding figures were 67% for stage 2, 63% for stage 3 and 60% for stage 4; the stage-specific differences were not statistically significant.
These service-use measures are provider-reported and do not measure whether care was clinically indicated, adequate or associated with healing. They describe care reported in 2004, not current practice.
Hospital-Acquired Pressure Ulcer Costs and Mortality
AHRQ’s 2017 report estimated the additional cost associated with a hospital-acquired pressure ulcer using three cost studies. The estimate is not a billed charge or a guaranteed individual cost.
| AHRQ outcome | Estimate | Measurement scope |
|---|---|---|
| Additional cost per case | $14,506 | 2016 U.S. dollars; U.S. hospitals |
| 95% confidence interval for cost | -$12,313 to $41,326 | 2016 U.S. dollars; U.S. hospitals |
| Excess mortality | 0.041 per case | 41 excess deaths per 1,000 cases; U.S. hospitals |
| 95% confidence interval for excess mortality | 0.013 to 0.093 per case | Model-based estimate; U.S. hospitals |
| Adult-inpatient sensitivity cost | $12,712; range $278–$25,145 | 2016 U.S. dollars; pediatric study excluded |
Source: Results: Estimating the Cost of Hospital-Acquired Conditions.
The cost interval crosses zero, showing substantial uncertainty in the additional-cost estimate. The mortality result is an excess-mortality estimate, not a crude case-fatality rate, and both outcomes were based on a small evidence base.
Italy Hospital-Acquired Pressure Ulcer Trends, 2018–2024
A peer-reviewed study used an adapted AHRQ PSI 03 administrative indicator and national hospital discharge records in Italy. Rates are reported per 10,000 eligible discharges, so they are not directly comparable with prevalence among residents or incidence per patient-day.
| Year | Crude hospital-acquired rate | Reported events |
|---|---|---|
| 2018 | 21.1 per 10,000 eligible discharges | 3,657 |
| 2019 | 17.2 per 10,000 eligible discharges | Not stated here |
| 2020 | 13.3 per 10,000 eligible discharges | 1,888 |
| 2021 | 13.2 per 10,000 eligible discharges | Not stated here |
| 2022 | 13.9 per 10,000 eligible discharges | Not stated here |
| 2023 | 14.6 per 10,000 eligible discharges | Not stated here |
Source: Nationwide Trends in Hospital-Acquired Pressure Ulcers, 2018–2024.
Across 2018–2024, the national median annual regional age-adjusted rate was approximately 14.0 per 10,000 eligible discharges. Overall crude regional rates differed sharply: Abruzzo recorded 48.5, Lazio 49.8, Friuli Venezia Giulia 1.1 and Emilia-Romagna 6.2 per 10,000 discharges over the period.
These regional figures are administrative rates, not risk-equivalent comparisons. Differences may reflect regional case mix, coding, recording, hospitalization patterns and service reorganization as well as prevention practice, while pandemic-era hospitalization changes may affect comparisons for 2020 and 2021.