Alternating-pressure mattresses and overlays were compared.
Alternating-pressure
surfaces, in which air-filled sacs are inflated and deflated
sequentially, can be used to prevent pressure ulcers in hospitalized
patients. In a British trial, investigators randomized 1972
mobility-impaired patients (age,
55) to be placed
on either alternating-pressure mattresses or less-expensive alternating-pressure
overlays (which are placed on top of conventional mattresses).
Alternating-pressure mattresses and overlays cost about US$7500 (UK£4000)
and $1850 (£1000), respectively.
In the clinical assessment, researchers found no difference between the mattresses and overlays in the proportions of patients who developed pressure ulcers of grade 2 or worse (about 10%). More patients in the overlay group than in the mattress group requested a change of surface due to discomfort (23% vs. 19%). A cost-effectiveness analysis showed that the mattresses yielded lower overall in-hospital costs (an average of about $530 [£283] per patient), mainly because of somewhat shorter lengths of stay and somewhat longer times to ulceration. Although differences in health benefits and total costs were not statistically significant, the analysis indicated an 80% probability that mattresses would be less costly than overlays during 2 years of use or longer.
Comment: These analyses indicated that alternating-pressure mattresses and alternating-pressure overlays yielded similar health outcomes. However, mattresses, which were somewhat more expensive initially, provided better long-term cost-effective protection against pressure ulcers in older mobility-impaired patients. At the time of publication, the full text of the outcome trial and the cost analysis was available free of charge.
— Keith I. Marton, MD
Citation(s):
Nixon J et al. Randomised, controlled trial of alternating pressure mattresses compared with alternating pressure overlays for the prevention of pressure ulcers: PRESSURE (pressure relieving support surfaces) trial. BMJ 2006 Jun 17; 332:1413-5.