ArticleEClinicalMedicine2019
Pressure Relieving Support Surfaces for Pressure Ulcer Prevention (PRESSURE 2): Clinical and Health Economic Results of a Randomised Controlled Trial.
Article in EClinicalMedicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 6 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
11 citing papers in PubMed, 6 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Effectiveness of surgical interventions in patients with severe pressure ulcers: the SIPS mixed-methods exploratory study.Health technology assessment (Winchester, England) · 2025Pooled it
- Alternating pressure (active) air surfaces for preventing pressure ulcers.The Cochrane database of systematic reviews · 2021Pooled it
- Beds, overlays and mattresses for treating pressure ulcers.The Cochrane database of systematic reviews · 2021Pooled it
- Reactive air surfaces for preventing pressure ulcers.The Cochrane database of systematic reviews · 2021Pooled it
- Foam surfaces for preventing pressure ulcers.The Cochrane database of systematic reviews · 2021Pooled it
- Alternative reactive support surfaces (non-foam and non-air-filled) for preventing pressure ulcers.The Cochrane database of systematic reviews · 2021Pooled it
- Barriers and Facilitators to Implementing Pressure Injury Guidelines for Nutrition Assessment and Alternating Pressure Air Mattress Allocation: A Qualitative Study.Journal of advanced nursing · 2025Article
- Economic costs attributable to modifiable risk factors: an analysis of 24 million urban residents in China.BMC medicine · 2024Article
- Evaluation of the Effect of Gluteus Maximus Contraction by Electrical Stimulation on Interfacial Pressure in Supine Bed Positions.Progress in rehabilitation medicine · 2024Article
- Article
- Lateral pressure equalisation as a principle for designing support surfaces to prevent deep tissue pressure ulcers.PloS one · 2019Article
Corrections and comments
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Authors and funding
16 authors at 5 institutions in 1 country.
Funding
Abstract
backgroundPressure ulcers (PUs) are complications of serious acute/chronic illness. Specialist mattresses used for prevention lack high quality effectiveness evidence. We aimed to compare clinical and cost effectiveness of 2 mattress types.
methodsMulticentre, Phase III, open, prospective, parallel group, randomised controlled trial in 42 UK secondary/community in-patient facilities.2029 high risk (acutely ill, bedfast/chairfast and/or Category 1 PU/pain at PU site) adult in-patients were randomised (1:1, allocation concealment, minimisation with random element) factors including: centre, PU status, facility and consent type. Interventions were alternating pressure mattresses (APMs) or high specification foam (HSF) for maximum treatment phase 60 days. Primary outcome was time to development of new PU Category ≥ 2 from randomisation to 30 day post-treatment follow-up in intention-to treat population. Trial registration: ISRCTN 01151335.
findingsBetween August 2013 and November 2016, we randomised 2029 patients (1016 APMs: 1013 HSF) who developed 160(7.9%) PUs. There was insufficient evidence of a difference between groups for time to new PU Category ≥ 2 Fine and Gray Model Hazard Ratio HR = 0.76, 95%CI0.56-1.04); exact P = 0.0890; absolute difference 2%). There was a statistically significant difference in the
interpretationIn high risk (acutely ill, bedfast/chairfast/Category 1 PU/ pain on a PU site) in-patients, we found insufficient evidence of a difference in time to PU development at 30-day final follow-up, which may be related to a low event rate affecting trial power. APMs conferred a small treatment phase benefit. Patient preference, low PU incidence and small group differences suggests the need for improved targeting of APMs with decision making informed by patient preference/comfort/rehabilitation needs and the presence of potentially modifiable risk factors such as being completely immobile, nutritional deficits, lacking capacity and/or altered skin/Category1 PU.
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Registered trials
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