Retrospective analysis of healing outcomes and associated factors in patients with pressure ulcers

Pressure ulcers (PUs) are serious complications among immobilized or chronically ill patients, often resulting in prolonged hospitalization, morbidity, and increased healthcare costs. Despite therapeutic advances, predictors of long-term healing remain unclear. This study aimed to identify factors associated with 1-year healing outcomes in patients with advanced PUs. This retrospective cohort study included adult patients diagnosed with PUs of grade 2 or higher between January 2020 and January 2025. Clinical, laboratory, and wound-related variables were obtained from electronic records, including demographic data, comorbidities, nutritional indicators, ulcer features (stage, location, size, infection, and bone exposure), and treatment modalities such as negative pressure wound therapy (NPWT) and surgical debridement. The primary outcome measure was complete wound healing within 12 months. Univariate and multivariate logistic regression analyses identified independent predictors of healing. A total of 240 patients (mean age, 61.5 ± 10.6 years; 69.6% male) were included in the final analysis. Complete healing at 12 months was achieved in 48.8% of the patients. In the multivariate logistic regression model, NPWT, hospital-based treatment, lower initial ulcer stage, and absence of paralysis were independently associated with complete healing, with all predictors reaching statistical significance (all P < .01). NPWT, hospital-based management, lower initial ulcer stage, and absence of paralysis were strongly associated with improved 1-year healing outcomes in patients with advanced PUs. These findings highlight the importance of early, structured wound care and suggest that both the treatment setting and patient mobility status play critical roles in long-term recovery.