Mike Piskie

Pressure injuries account for 27% of all hospital-acquired conditions nationally and cause 45.4% of all HAC-related deaths, 28,901 per year. They kill more patients annually than adverse drug events, falls, surgical site infections, CLABSI, and VAP combined. PIs are the only HAC that has increased while all others have declined.

Key Takeaways
For the average 160-bed US hospital, preventable pressure injuries generate $5.97 million in annual financial risk – $3.87 million in lost reimbursement, $2.1 million in litigation exposure, 911 added hospital days, 149 patients who could not be admitted, and 16.4 deaths. Every one of those costs is unreimbursed, unavoidable, and growing.

Despite CMS payment penalties and widespread adoption of prevention guidelines, severe pressure ulcer prevalence – Stages 3, 4, and unstageable – increased from 2008 to 2019. Between 2013 and 2016 alone, PI rates rose 29.4%, the only hospital-acquired condition to increase, while every other HAC declined. The most dangerous injuries are getting more common, not less.

In the largest US ICU prevalence survey – 41,866 critical care patients across 1,801 facilities – DTIs were the #1 HAPI stage at 33.6%, followed by Stage 2 at 28.1%. Together they account for nearly two-thirds of all ICU HAPIs. ICU patients are 4x more likely to develop severe PIs than superficial ones, and HAPI rates have not improved since 2013, even in the nation’s highest-resourced units.

Analyzing 1.25 million US patients with pressure injuries, this 2025 study found self-pay patients faced the longest stays – an increase of 3.91 additional days – and incurred $21,216 more in costs compared to Medicare patients. Hispanic patients incurred $37,647 more in costs and 1.42 additional days versus White patients. Pressure injuries don’t distribute their harm equally — they fall hardest on those least equipped to absorb it.

Hospitals are named as defendants in 62% of pressure ulcer malpractice cases, with mean payouts of $1.6–$2.5 million when they lose. Nursing homes face mean awards exceeding $4 million. Negligence, not malpractice, is the primary claim in 76% of cases, meaning jurors view pressure injuries as failures of basic care, not complex medical judgment.

Plaintiffs recovered damages in 87% of pressure ulcer lawsuits with a median settlement of $1.06 million, and awards reaching as high as $312 million. More than 17,000 PI-related lawsuits are filed in the US annually – making pressure injuries the second most common cause of malpractice claims. Even facilities that believed their care was adequate routinely settled rather than face a jury.

Patients with pressure injuries experience severely diminished quality of life across every dimension – physical, emotional, social, and cognitive. Pain is the defining and relentless feature, described by patients as leading to helplessness, despair, and complete dependence. Behind every statistic is a person whose life has been fundamentally diminished by a preventable wound.

Among 676,435 hospitalized patients with pressure ulcers, median length of stay was 7 days versus 3 days for those without – more than double. Hospital stays involving a pressure ulcer may incur additional annual charges of up to $700,000. Patients with PIs were significantly more likely to have longer stays, higher charges, and worse outcomes across every measured variable.