Pressure injury risk factors in adult orthopaedic surgical patients: a cross-sectional study and random forest.

Abstract

To identify the most important risk factors for predicting pressure injury (PI) occurrence in adult orthopaedic surgical patients based on investigation data, thereby identifying at-risk patients and facilitating formulation of an effective patient care strategy. Patients were assessed with an instrument designed by the authors specifically for this study in a cross-sectional investigation following the STROBE checklist. The random forest method was adopted to select the most important risk factors and predict occurrence of PIs. A dataset of 27 risk factors from 1701 patients was obtained. A subset of the 15 most important risk factors was identified. The random forest method had a high prediction accuracy of 0.9733 compared with 0.9281 calculated with a logistic model. Results indicated that the selected 15 risk factors, such as activity ability, friction/shear force, skin type and anaesthesia score, performed very well in predicting the occurrence of PIs in adult orthopaedic surgical patients.