Data-driven approach to predicting the risk of pressure injury: A retrospective analysis based on changes in patient conditions.

Abstract

To determine the risk of pressure injury development in the intensive care unit based on changes in patient conditions. This retrospective study was based on secondary data analysis. Patient data from electronic health records were retrospectively obtained and we included 438 and 1752 patients with and without pressure injury, respectively, among those admitted to the medical and surgical intensive care units (ICUs) from January 2017-February 2020. Changes in patient conditions were analysed based on the first and last objective data values from the day of ICU admission to the day before the onset of pressure injury and categorised as follows: improved, maintained normal, exacerbated and unchanged. Logistic regression was performed to identify the significant predictors of pressure injury development based on 11 variables. The 11 selected variables were age, body mass index, activity, acute physiology and chronic health evaluation II score, nursing severity level, pulse and albumin, haematocrit, C-reactive protein, total bilirubin and blood urea nitrogen levels. The risk for a pressure injury was high with exacerbation of or persistently abnormal levels of nursing severity, albumin, haematocrit, C-reactive protein, blood urea nitrogen and pulse >100 beat/min. Periodic monitoring of haematological variables is important for preventing pressure injury in the intensive care unit. The study followed STROBE guidelines. This study contributes to the utilisation of patient data from electronic health records. In addition to other pressure injury risk assessment tools, ICU nurses can help prevent pressure injuries by assessing patients' blood test results, thereby promoting patient safety and enhancing the efficacy of nursing practice.