# Large-Scale Data Analytics of the Romanian National Inpatient Database: Prevalence, Incidence, and Mortality of Chronic Wounds, 2017–2022

## TL;DR

This study analyzed Romania's inpatient data to assess chronic wound prevalence, incidence, and mortality from 2017 to 2022, revealing trends affected by the pandemic and high-risk groups.

## Contribution

The study introduces a validated computational framework for analyzing chronic wound burden in Romania using national inpatient data.

## Key findings

- Hospital-treated chronic wound prevalence and incidence peaked pre-pandemic and declined during 2020–2021.
- Venous ulcers were most common, while pressure ulcers had the highest mortality despite being least frequent.
- The burden was concentrated in adults aged ≥65 years and in men.

## Abstract

Background and Objectives: Assessing the national burden of chronic wounds is a complex data analytics challenge. Robust estimates in Eastern Europe are scarce, highlighting the need for computational methods to validate cases in large-scale health databases. Materials and Methods: We applied a large-scale data analytics approach to Romania’s National Inpatient Database (public hospitals, 2017–2022). A computational case-ascertainment algorithm (validated “≥2 admissions” rule) was used to identify recurrently hospitalized patients, establishing a cohort of 18,856 patients (65,771 hospitalizations). We computed annual prevalence, incidence, and mortality per 100,000 adults, stratified by ulcer categories, age, and sex. Results: Hospital-treated prevalence and incidence showed a clear pre-pandemic peak followed by a marked decline in 2020–2021 and only partial rebound by 2022, consistent with pandemic-related disruption of inpatient care. Population-level mortality remained low, but pressure ulcers, although least frequent, accounted for the highest mortality burden. Venous ulcers were the most common category, and the hospital-treated burden was concentrated in adults aged ≥ 65 years and in men. Conclusions: This nationwide data-analytics framework provides the first validated inpatient indicators of chronic ulcer burden in Romania and demonstrates substantial hospital-treated disease burden with pronounced sensitivity to healthcare access constraints. Clinical Implications: The findings can support health-policy and prevention strategies by prioritizing early detection and integrated hospital–community wound care pathways for high-risk groups (men and older adults) and by strengthening outpatient services to reduce avoidable admissions.