Asociación entre la carga de comorbilidad y la gravedad de las lesiones por presión en personas mayores hospitalizadas, México, 2026.
DOI:
https://doi.org/10.63535/05n5xw83Keywords:
Comorbilidad; Lesiones por presión; Personas mayores; Asociación, Gravedad.Abstract
El envejecimiento poblacional ha incrementado la prevalencia de enfermedades crónicas y la complejidad clínica de las personas mayores hospitalizadas. En este contexto, la carga de comorbilidad representa un indicador relevante al reflejar el impacto acumulativo de las enfermedades sobre funcionalidad y desenlaces en salud (Nicholson et a., 2019). Objetivo: analizar la asociación entre la carga de comorbilidad y la gravedad de las lesiones por presión en personas mayores. Metodología: enfoque cuantitativo de tipo observacional, transversal y correlacional. Se realizó un muestreo no probabilístico por conveniencia, con una muestra integrada por 26 personas mayores con los criterios de inclusión; firma de consentimiento informado, 60 años o más, diagnóstico de al menos una lesión por presión, y estancia hospitalaria durante el periodo de estudio. Instrumentos: la carga de comorbilidad se evaluó mediante el índice de comorbilidad de Charlson (ICC) y la gravedad de lesiones mediante Bates-Jensen Wound Assesment Tool. Resultados: el (53.8%) presento carga de comorbilidad moderada, el (38.5%) carga alta, y (7.7%) carga baja. Se observó una tendencia progresiva al incremento de la gravedad de lesiones por presión conforme aumentó la carga de comorbilidad. Sin embargo, las pruebas de Kruskal-Wallis (p = 0.387), correlación de Spearman (ρ = 0.30, p = 0.136) y chi cuadrada (χ² = 1.89; p = 0.755) no mostraron asociaciones estadísticamente significativas. Discusión: Los hallazgos sugieren una tendencia clínica hacia una mayor gravedad de las lesiones en personas mayores con mayor carga de comorbilidad, consistente con los mecanismos fisiopatológicos descritos para la multimorbilidad. Conclusiones: se recomienda realizar estudios multicéntricos con muestras de mayor tamaño que permitan confirmar la asociación y fortalecer la evidencia para la atención integral de las personas mayores.
Downloads
References
Beard, J. R., Officer, A., de Carvalho, I. A., Sadana, R., Pot, A. M., Michel, J. P., Lloyd-Sherlock, P., Epping-Jordan, J. E., Peeters, G., Mahanani, W. R., Thiyagarajan, J. A., & Chatterji, S. (2016). The World report on ageing and health: A policy framework for healthy ageing. The Lancet, 387(10033), 2145–2154. https://doi.org/10.1016/S0140-6736(15)00516-4 DOI: https://doi.org/10.1016/S0140-6736(15)00516-4
Bates-Jensen, B. M., Vredevoe, D. L., & Brecht, M. L. (1992). Validity and reliability of the Pressure Sore Status Tool. Decubitus, 5(6), 20–28.
Charlson, M. E., Pompei, P., Ales, K. L., & MacKenzie, C. R. (1987). A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. Journal of Chronic Diseases, 40(5), 373–383. https://doi.org/10.1016/0021-9681(87)90171-8 DOI: https://doi.org/10.1016/0021-9681(87)90171-8
Coleman, S., Nixon, J., Keen, J., Wilson, L., McGinnis, E., Dealey, C., Stubbs, N., Farrin, A., Dowding, D., Schols, J. M. G. A., Cuddigan, J., Berlowitz, D., Jude, E., Vowden, P., Schoonhoven, L., Bader, D. L., Gefen, A., Oomens, C. W. J., Nelson, E. A., … Clark, M. (2014). A new pressure ulcer conceptual framework. Journal of Advanced Nursing, 70(10), 2222–2234. https://doi.org/10.1111/jan.12405 DOI: https://doi.org/10.1111/jan.12405
Edsberg, L. E., Black, J. M., Goldberg, M., McNichol, L., Moore, L., & Sieggreen, M. (2016). Revised National Pressure Ulcer Advisory Panel Pressure Injury Staging System. Journal of Wound, Ostomy and Continence Nursing, 43(6), 585–597. https://doi.org/10.1097/WON.0000000000000281 DOI: https://doi.org/10.1097/WON.0000000000000281
European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel, & Pan Pacific Pressure Injury Alliance. (2019). Prevention and treatment of pressure ulcers/injuries: Clinical practice guideline. EPUAP/NPIAP/PPPIA.
Feinstein, A. R. (1970). The pre-therapeutic classification of co-morbidity in chronic disease. Journal of Chronic Diseases, 23(7), 455–468. https://doi.org/10.1016/0021-9681(70)90054-8 DOI: https://doi.org/10.1016/0021-9681(70)90054-8
López-Otín, C., Blasco, M. A., Partridge, L., Serrano, M., & Kroemer, G. (2023). Hallmarks of aging: An expanding universe. Cell, 186(2), 243–278. https://doi.org/10.1016/j.cell.2022.11.001 DOI: https://doi.org/10.1016/j.cell.2022.11.001
Moore, B. J., White, S., Washington, R., Coenen, N., & Elixhauser, A. (2017). Identifying increased risk of readmission and in-hospital mortality using hospital administrative data: The AHRQ Elixhauser Comorbidity Index. Medical Care, 55(7), 698–705. https://doi.org/10.1097/MLR.0000000000000735 DOI: https://doi.org/10.1097/MLR.0000000000000735
Nicholson, K., Makovski, T. T., Griffith, L. E., Raina, P., Stranges, S., & van den Akker, M. (2019). Multimorbidity and comorbidity revisited: Refining the concepts for international health research. Journal of Clinical Epidemiology, 105, 142–146. https://doi.org/10.1016/j.jclinepi.2018.09.008 DOI: https://doi.org/10.1016/j.jclinepi.2018.09.008
Nicholson, K., Terry, A. L., & Fortin, M. (2019). Prevalence, characteristics, and patterns of multimorbidity in primary care: A systematic review. Family Practice, 36(4), 462–470. https://doi.org/10.1093/fampra/cmy079 DOI: https://doi.org/10.1093/fampra/cmy079
Organización Mundial de la Salud. (2022). Decade of healthy ageing: Baseline report. World Health Organization.
Organización Mundial de la Salud. (2023). Integrated care for older people (ICOPE): Guidance for person-centred assessment and pathways in primary care. World Health Organization.
Quan, H., Li, B., Couris, C. M., Fushimi, K., Graham, P., Hider, P., Januel, J. M., & Sundararajan, V. (2011). Updating and validating the Charlson comorbidity index and score for risk adjustment in hospital discharge abstracts using data from 6 countries. American Journal of Epidemiology, 173(6), 676–682. https://doi.org/10.1093/aje/kwq433 DOI: https://doi.org/10.1093/aje/kwq433
Rothman, K. J., Greenland, S., & Lash, T. L. (2021). Modern epidemiology (4th ed.). Wolters Kluwer.
Valderas, J. M., Starfield, B., Sibbald, B., Salisbury, C., & Roland, M. (2009). Defining comorbidity: Implications for understanding health and health services. Annals of Family Medicine, 7(4), 357–363. https://doi.org/10.1370/afm.983 DOI: https://doi.org/10.1370/afm.983
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Enid Asvany Guzmán Caballero, Bárbara Dimas Altamirano, Jaime Alberto Rangel Bernal, Marlen Fabela Mixuxi, Helí Jesset Álvarez Hernández (Autor/a)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright and Licensing Notice
1. Retention and Assignment of Rights
Authors who publish in the Prospherus Scientific Journal retain the Copyright of their works, granting the journal the right of first publication. This initial publication is carried out under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0).
2. Conditions for Reuse
The CC BY-NC-ND 4.0 license allows any user to read, download, copy, and distribute the published work, provided that the following three conditions are strictly met:
-
Attribution (BY): Clear and explicit mention of the work's authorship must be made, and the original publication in this journal must be cited.
-
NonCommercial (NC): The use of the material must always be for non-commercial purposes.
-
NoDerivatives (ND): The work must be maintained in its original integrity, and modification, adaptation, or creation of derivative works (such as translations or remixes) based on the article is not permitted.
3. Additional Contractual Agreements and Repositories
Authors are permitted to enter into other independent and additional contractual agreements for the non-exclusive distribution of the published version of the article (for example, including it in an institutional repository or on a personal website) provided that:
-
It is unequivocally indicated that the work was first published in the Prospherus Scientific Journal.
-
The redistribution respects the restrictive terms of the CC BY-NC-ND 4.0 license (non-commercial use and no modifications).
4. Disclaimer
The Prospherus Scientific Journal will in no case be liable for any direct, indirect, incidental, punitive, or consequential claims of copyright infringement related to articles that have been published in any of its issues. Responsibility for originality and obtaining permissions for third-party material rests entirely with the authors.
