Risk Factors For Pressure Injury Research Articles

Incidence and Risk Factors for Perioperative Pressure Injuries: Prospective Descriptive Study

PurposePressure injuries can often occur in patients undergoing surgical, diagnostic, or other invasive procedures, so it is important to assess patients in the perioperative period. This study was conducted to determine the incidence and risk factors of perioperative pressure injury. DesignA cross-sectional, prospective, and descriptive study. MethodsThis study involved 158 patients who met the study's eligibility criteria between May 2022 and July 2022. The data were collected using the Patient Information Form, Munro Scale, Braden Scale, and pressure injury staging form. The patients were monitored postoperatively or for 3 days. FindingsPressure injury developed in 13.9% of the patients. Perioperative risk factors were age, edema, mobilization time, parenteral nutrition, blood transfusion, and glucose level, while preoperative albumin level was lower in patients with pressure injury. In the postoperative period, the risk factors were duration of mobilization and transition to oral feeding, length of intensive care unit stay, and low Braden score. In multivariate analysis, the variables that showed significance with the risk of pressure injury were postoperative Munro score and edema. ConclusionsIt is crucial to evaluate the risk factors for pressure injury in patients who have undergone surgical procedures.

Altered serum transferrin levels are associated with pressure injury and its stages: A case-control study

Abstract Background: Despite the measures taken to the traditional risk factors for pressure injury (PI), there is still a great residual risk. Therefore, on the basis of managing traditional risk factors, it is necessary to find and interpret interventionable factors for predicting and treating PI. Objective: To investigate the relationship between serum transferrin level and the severity of PI. Methods: PI patients from The Affiliated Hospital of Qingdao University between July 2020 and June 2021 were selected as the case group, which was further divided into stage 1 (30 patients), stage 2 (59 patients), stage 3 (64 patients), and stage 4 (43 patients) according to PI stage. The control group consisted of 196 bedridden patients of similar age who did not have a PI and were matched to the cases by sex and age. This study evaluated the serum transferrin level between the case and control groups. Results: The serum transferrin levels were statistically significant between the control and case groups (P<0.001). The serum transferrin level of PI patients with stages 3 and 4 was significantly lower than that of patients with stages 1 and 2 (P<0.05). After adjusting for covariates, serum transferrin remained negatively associated with PI occurrence (B=−0.045, adjusted OR=0.956, P<0.001) and stage (B=−2.266, adjusted OR=0.104, P<0.001). Conclusions: The serum transferrin level was decreased with the progression of PI. This study suggests that serum transferrin can serve as positive evidence for treating PI patients.

Risk factors for pressure injuries in individuals with spinal cord injuries who have sarcopenic obesity: A comparison of time-dependent changes in sacral region pressure between individuals with and without sarcopenic obesity

Objective To identify the risk factors for pressure injuries in individuals with spinal cord injuries (SCIs) who have sarcopenic obesity, comparing time-dependent changes in sacral region pressure in individuals with and without sarcopenic obesity. Design An experimental time series study. Setting Single-center hospital. Participants Twenty-five adult participants with subacute and chronic paraplegia who visited our rehabilitation center, Republic of Korea, between May 2021 and June 2022. Interventions Whole-body dual-energy X-ray absorptiometry was performed to diagnose sarcopenic obesity. After the participants were placed in the supine position for 1 hour, the average pressure (mmHg), peak pressure (mmHg), and total contact area (cm2) of the sacral region were measured using the pressure-mapping system. Results Compared with the non-sarcopenic obesity group, the sarcopenic obesity group showed significant before-and-after differences in peak pressure. Furthermore, the risk factors that were significantly associated with peak pressure in the sarcopenic obesity group were the American Spinal Injury Association Impairment Scale score and the fat mass index. Conclusion Among participants with SCIs, the risk of pressure injuries is higher in the sarcopenic obesity group than in the non-sarcopenic obesity group. Notably, the risk of pressure injuries increases in participants who have complete injury and an increased fat mass index, indicating the importance of close monitoring and more active management to prevent pressure injuries in this subpopulation.

Urinary Catheter-Related Meatal Pressure Injury Risk Factors in Male Critical Care Patients: A Prospective Repeated-Measures Study.

Urinary catheter-related meatal pressure injury (UCR-MPI) is a preventable and serious complication of indwelling urinary catheter use. This prospective study aimed to determine the prevalence and risk factors of UCR-MPI in male critical care patients. A total of 138 male patients 18 years and older using an indwelling urinary catheter were included in the study. Participants' perineal areas were assessed daily for the development of MPI. The UCR-MPI prevalence was 26.1% (n = 36/138). Most patients (61.1%) had a grade I UCR-MPI with intact skin and mucosa and nonblanchable erythema. Urinary catheter irrigation (P = .001), lower Braden Scale scores (P = .040), lower Glasgow Coma Scale score (P = .002), higher Itaki Fall Risk Scale score (P = .040), higher dependency level (P = .027), hypoalbuminemia (P = .002), and perineal edema (P = .001) were risk factors for UCR-MPI. The prevalence of UCR-MPI was high in this sample. Providers should take preventive measures to prevent UCR-MPI in patients with a penis including early and frequent risk assessment.

A machine learning algorithm-based predictive model for pressure injury risk in emergency patients: A prospective cohort study

ObjectivesTo construct pressure injury risk prediction models for emergency patients based on different machine learning algorithms, to optimize the best model, and to provide a suitable assessment tool for preventing the occurrence of pressure injuries in emergency patients. MethodsA convenience sampling was used to select 312 patients admitted to the emergency department of a tertiary care hospital in Tianjin, China, from May 2022 to March 2023, and the patients were divided into a modeling group (n = 218) and a validation group (n = 94) in a 7:3 ratio. Based on the results of one-factor logistic regression analysis in the modeling group, three machine learning models, namely, logistic regression, decision tree, and neural network, were used to establish a prediction model for pressure injury in emergency patients and compare their prediction effects. The optimal model was selected for external validation of the model. ResultsThe incidence of pressure injuries in emergency patients was 8.97 %, 64.52 % of pressure injuries occurred in the sacrococcygeal region, and 64.52 % were staged as stage 1. Serum albumin level, incontinence, perception, and mobility were independent risk factors for pressure injuries in emergency patients (P < 0.05), and the area under the ROC curve of the three models was 0.944–0.959, sensitivity was 91.8–95.5 %, specificity was 72.2–90.9 %, and the Yoden index was 0.677–0.802; the decision tree was the best model that The area under the ROC curve for the validation group was 0.866 (95 % CI: 0.688–1.000), with a sensitivity of 89.8 %, a specificity of 83.3 %, and a Yoden index of 0.731. ConclusionsThe decision tree model has the best predictive efficacy and is suitable for individualized risk prediction of pressure injuries in emergency medicine specialties, which provides a reference for the prevention and early intervention of pressure injuries in emergency patients.

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

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.

Cross-setting Comparison of Risk Factors for Pressure Injuries Acquired in Post-Acute Care.

To provide information on the association between risk factors and the development of new or worsened stage 2 to 4 pressure injuries (PIs) in patients in long-term care hospitals (LTCHs), inpatient rehabilitation facilities (IRFs), and skilled nursing facilities (SNFs). This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. After participating in this educational activity, the participant will:1. Compare the unadjusted PI incidence in SNF, IRF, and LTCH populations.2. Explain the extent to which the clinical risk factors of functional limitation (bed mobility), bowel incontinence, diabetes/peripheral vascular disease/peripheral arterial disease, and low body mass index are associated with new or worsened stage 2 to 4 PIs across the SNF, IRF, and LTCH populations.3. Compare the incidence of new or worsened stage 2 to 4 PI development in SNF, IRF, and LTCH populations associated with high body mass index, urinary incontinence, dual urinary and bowel incontinence, and advanced age.

Pressure injury risk factors in patients undergoing general anesthesia surgeries.

Pressure injuries result from prolonged pressure and lead to tissue damage, infections, extended recovery times, and an economic burden. To explore risk factors for pressure injuries in patients who underwent surgery under general anesthesia. This retrospective study included patients who underwent surgery at a regional educational hospital in southern Taiwan from January 1, 2018, through December 31, 2018. A comprehensive multivariate analysis was used to identify the prominent risk factors for pressure injury among the 11 231 patients enrolled in this study. These risk factors were an age of ≥65 years; surgery duration of >120 minutes; diastolic blood pressure of <60 mm Hg for >30 minutes during surgery; intraoperative use of dopamine, norepinephrine, or epinephrine as vasopressors; American Society of Anesthesiologists physical classification of III or higher; minimum intraoperative body temperature of ≤35°C; blood loss of >500 mL; and a supine or prone surgical position. This study identified several pressure injury risk factors related to surgical conditions and patient characteristics. Surgical teams must monitor, control, and manage these factors, prioritize staff education, and adopt preventive protocols.

Epidemiological characteristics and prevention of pressure injury in older inpatients of Zhuang and Han ethnicity in Guangxi, China: a cross-sectional study.

Pressure injury (PI) is a significant health concern among older inpatients, particularly in regions with diverse ethnic populations. Understanding the epidemiological characteristics and preventive measures is crucial for improving patient outcomes. To analyze the epidemiological characteristics, prevention status, and influencing factors of pressure injury (PI) in older inpatients of Zhuang and Han nationality in Guangxi, China. A total of 2206 inpatients age 60 years or older in 2 class III grade A general hospitals in the Guangxi Zhuang Autonomous Region between April 1, 2021, and May 27, 2021, were included in this cross-sectional study. Epidemiological characteristics-including age, sex, educational background, race, ethnicity, and hospitalization information-were collected using a general information questionnaire designed by the researchers. The PI risk factors were evaluated using the Braden Scale. Prevention status was assessed using the Epidemiology and Prevention Skin Injuries in the Elderly Scale and Skin Injury Survey Scale. Of the total 2206 patients included in the study, 555 (25.16%) were of Zhuang nationality and 1651 (74.84%) were of Han nationality. The overall PI incidence was 2.58%, with PI prevalence of 1.80% and 2.85% in Zhuang and Han patients, respectively. The main influencing factor for PI in Zhuang patients was caregivers (P < .05), whereas in Han patients the main influencing factors were urinary conditions, Alzheimer disease, sedatives, and antihypertensive drugs (P < .05). The PI prevalence rates were similar in both ethnic groups. Health care staff in high-risk departments for PI must remain vigilant and take appropriate action.

Nomogram model on estimating the risk of pressure injuries for hospitalized patients in the intensive care unit

ObjectivesThis study aimed to build and validate a nomogram model to estimate the risk of pressure injuries in intensive care unit patients. DesignMulticenter prospective cohort study. Setting33 tertiary hospitals in the Gansu Province, China. Measurements and main resultsThis study included 6420 patients between April 2021 to October 2022 from an information platform of pressure injury risk management called the “Long Hu Hui.” Univariate and multivariate logistic regression analyses identified pressure injury risk factors to be included in the nomogram. The resulting nomogram was tested for calibration discrimination, and clinical usefulness. Of the included patients, 77 developed pressure injuries, representing an incidence rate of 1.2 %. Analysis of binary logistic regression revealed that the estimation nomogram included weight loss greater than 5 kg in the last three months, pneumotomy cannula, thoracic catheter, isoproterenol, norepinephrine, abnormal skin color, ruptured erythema, stroke, increased body temperature and nonspecific patients (specific patients include paralysis, unconsciousness, dementia, forced body position). The area under the receiver operating characteristic curve for the training cohort was 0.806 (95 % CI 0.755–0.857), and the AUC of the text cohort was 0.737 (95 % CI 0.574–0.901). The model has excellent calibration in both the training cohort (H-L test: χ2 = 6.34, P = 0.61) and the text cohort (H-L test: χ2 = 4.50, P = 0.81). Furthermore, the decision curve analysis revealed the preferred net benefit and the threshold probability in the estimation nomogram. ConclusionsThe nomogram model accurately estimated the risk of pressure injuries among intensive care patients, it should be used to inform risk assessment and facilitate early intervention strategies in future practice. Implications for clinical practiceThe nomogram allows intensive care providers to dynamically assess the patient's risk of pressure injuries and to implement more targeted interventions accordingly.

Intrinsic and Extrinsic Risk Factors for Nosocomial Pressure Injury among Hospitalized Adults at a Tertiary Hospital in Western Kenya

The high incidence and prevalence of nosocomial pressure injuries pose a threat to safe hospitalization and additional strain on the healthcare system. Analysis of pressure injury risk factors is necessary for efficient prevention and management as part of the program to ensure that no patient experiences any preventable harm while receiving care, as per the international patient safety goals. This study evaluated the intrinsic and extrinsic risk factors for pressure injury among cohorts of hospitalized adults using a prospective approach. The Braden Scale was used to assess the participants’ level of risk and classify low (score 15 to 23) and high (score 6 to 14) cohorts prior to follow-up. Binary regression analysis was used to establish an association between the risk factors and the development of stage 2 and above pressure injuries and the odds reported. The intrinsic factors—nutrition, sex, age, and primary diagnosis—influenced the occurrence of pressure injuries. Similarly, the extrinsic factors—sensory perception, moisture, mobility and activity, presence of a medical device, friction, and shear—showed an association with the development of pressure injuries. Poor nutrition, impaired mobility, and persistent moisture, however, were statistically the most significantly associated risk factors, at OR 18.20, CI 2.18–151.69, p =.01; OR 20.93, CI 1.13–387.92, p =.04; OR 16.11, CI 2.02–128.52, p =.01, respectively, confirming a significant association between intrinsic and extrinsic risk factors and the development of hospital-acquired pressure injury. These identified risk factors can be used to tailor intervention earlier on admission and avert these preventable injuries. Standardized, timely risk assessment and proactive addressing of the identified risk factor among hospitalized patients are therefore recommended.

Incidence and risk factors for pressure injury in hospitalized non-small cell lung cancer patients: A retrospective observational study

AimThis study aimed to identify the incidence and risk factors for pressure injury in patients hospitalized for non-small cell lung cancer (NSCLC). MethodsThis retrospective observational study was conducted in 645 adults who were hospitalized for NSCLC. Clinicopathological characteristics were compared between NSCLC patients with pressure injury and those without pressure injury. ResultsAmong total 645 patients, 180 patients showed pressure injury with an incidence of 27.9%. Patients with pressure injury showed increased serum C-reactive protein (CRP) levels (P < 0.001), increased neutrophil-lymphocyte ratio (P = 0.002), and increased platelet-lymphocyte ratio (P = 0.001) more often. Increase in serum CRP levels at the time of admission was the major risk factor for development of pressure injury in NSCLC patients (OR = 2.20; 95% CI [1.40–3.45]; P = 0.001). Also, among major inflammatory markers, serum CRP levels at the time of admission showed weak negative correlation with the period from admission to the development of pressure injury (r = −0.216, P = 0.004). ConclusionBy checking serum CRP levels at the time of admission, the NSCLC patients at high risk for the development of pressure injury can be identified in advance and the occurrence of pressure injury can be reduced by applying more active preventive nursing care. Clinical trial registration numberKCT0006570.

Assessment of the risk factors for intraoperative pressure injuries in patients

AimThis study was conducted to assess the risk factors for pressure injuries in patients during surgery. MethodsIn this descriptive cross-sectional study, the risk of pressure injuries during surgery was evaluated in 250 patients in a university hospital. Data were collected through a Patient Descriptive Information Form (PDIF) and the 3S Intraoperative Pressure Injury Risk Assessment Scale (IPIRAS). ResultsThe mean age of the patients was 44.15 ± 17.00, and 52.4% were female. In addition, it was determined that the mean 3S IPIRAS score was higher in patients who were male, were aged ≥60 years, were obese, had a chronic disease, and had low serum albumin and hemoglobin levels (p < .05). During the surgery of the patients included in the study, support surfaces were used in 67.6%, positioning aids were used in 82.4%, and 55.6% had normal skin. Patients who underwent CVS procedures for more than 6 h, did not use support surfaces during surgery, had moist skin, or used vasopressors had higher and significantly different mean 3S IPIRAS scores (p < .05). ConclusionsAccording to the results, all surgical patients were at risk for pressure injury in the intraoperative period. In addition, it was found that male gender was associated with risk factors and that being aged ≥60 years, obesity, chronic disease, low serum hemoglobin and albumin levels, CVS, operations lasting more than 6 h, moist skin, vasopressor drugs, and not using support surfaces during surgery increased the risk of pressure injuries significantly.

Cross-setting Comparison of Risk Factors for Pressure Injuries Acquired in Post-Acute Care.

To provide information on the association between risk factors and the development of new or worsened stage 2 to 4 pressure injuries (PIs) in patients in long-term care hospitals (LTCHs), inpatient rehabilitation facilities (IRFs), and skilled nursing facilities (SNFs). This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care. After participating in this educational activity, the participant will:1. Compare the unadjusted PI incidence in SNF, IRF, and LTCH populations.2. Explain the extent to which the clinical risk factors of functional limitation (bed mobility), bowel incontinence, diabetes/peripheral vascular disease/peripheral arterial disease, and low body mass index are associated with new or worsened stage 2 to 4 PIs across the SNF, IRF, and LTCH populations.3. Compare the incidence of new or worsened stage 2 to 4 PI development in SNF, IRF, and LTCH populations associated with high body mass index, urinary incontinence, dual urinary and bowel incontinence, and advanced age.

Cross-setting Comparison of Risk Factors for Pressure Injuries Acquired in Post-Acute Care.

Cross-setting Comparison of Risk Factors for Pressure Injuries Acquired in Post-Acute Care.

Risk Factors Associated With Pressure Injuries in Surgical Patients: A Retrospective Case-Control Study.

This study aimed to identify predictive risk factors for pressure injury (PI) occurring during surgery. Retrospective case-control study. Data on records of 6070 patients hospitalized for surgery at Seoul National University Bundang Hospital located in Seoul Korea. Data were collected between May 2013 and December 2014. Anonymized data from patients were accessed via electronic health records, nursing records, direct patient assessment, surgical, clinical laboratory, and anesthesia records, preanesthesia status evaluations, and PI incident reports, and transfusion and extracorporeal circulation reports. Descriptive and logistic regression analyses were conducted. Three hundred eighty-one of the 6070 patients (6.3%) developed within 24 hours a PI that was associated with surgery. The most common locations for the PIs were the coccyx (15.1%; n = 75) and trunk (chest or abdomen; 15.1%; n = 75). All PIs were classified as stage 1 (66.6%; n = 331) or 2 (33.4%; n = 166). Based on logistic regression results, we found that the risk factors that were independently predictive of surgery-related PIs were patient position during surgery, admission to an intensive care unit after surgery, required blood transfusion during surgery, and duration of surgery. This retrospective study identified several risk factors associated with a higher incidence of perioperative PIs in surgical patients. A PI prevention program accounting for these factors could potentially help prevent PIs and their costly complications.

Novel Smart Sensor Platform for Monitoring Multiple Pressure Injury Risk Factors: A Feasibility Study in a Post-Acute Care Facility.

Posture, temperature, and moisture have been identified as critical modifiable risk factors in pressure injury (PI) development. Microclimate is defined as temperature and humidity at the interface of the support surface and body. To our knowledge, no studies have used sensor technology to measure these parameters simultaneously in real time. Continuous monitoring of repositioning and microclimate provide real-time actionable insights to help deliver personalized care and measure the effectiveness of interventions. To evaluate the ability of a smart surface platform to collect and document clinical data on monitoring patients' movement and microclimate simultaneously and to compare data generated to nursing observations in order to construct an algorithm that is expected to evolve over time: (1) comparing the blinded data from nurses interacting with the patients and the system; and (2) data being collected is validating an algorithm that is expected to become more accurate over time. This prospective, descriptive single-site trial was conducted at a tertiary care facility in a large urban centre in Canada. Patients identified at risk of PIs received standard of care while placed on the smart surface for timed intervals. Nurses' assessment data were collected at three hourly timepoints using a comprehensive tool developed for the study. Sensors monitored patients' interface pressure moisture and temperature every four seconds. A comparative statistical analysis was conducted between the two datasets retrospectively. The study included a total of 104 participants; mean age of 59 years (range 21-92, ± 19.15). Sensor monitoring hours (1,407) generated 1,101,780 frames of surface data. A total of 511 nursing assessments were recorded during the study period. Sensor-generated data correlated strongly with nurse-collected data at cross-sectional intervals. There was a high level of agreement between information collected from sensors and nursing assessments: 94.7% for moisture (p<0.05), and 87.1% for temperature (p<0.05). Nurse-recorded posture assessments were compared to the smart surface platform interface pressure visualizations to determine the device's posture detection, resulting in a 92% accordance (matching 552 out of 600 nurse postures), with a binomial test determining the posture results to be statistically significant (p<0.05) (CI 95%). In addition, moisture events were matched to nurse assessments with 94.7% in accordance, identifying 39 bladder incontinence and 93 non-urinary moisture events (125 total events captured out of 132). The technology's ability to capture PI risk factors supports nursing practice. Supplementary data generated has the potential to improve efficiency of professional caregiver workflow and patient outcomes by informing targeted microclimate management strategies and decreasing unnecessary interventions. The large volume of data collected will be used as a basis for artificial intelligence applications with the potential to inform other clinical decision-making areas.

Incidence of and risk factors for self-load-related and medical device-related pressure injuries in critically ill patients: A prospective observational cohort study.

There are two types of pressure injuries: self-load-related pressure injuries (PIs) and medical device-related pressure injuries (MDRPIs), but the differences in risk factors between PIs and MDRPIs have not yet been clarified. If risk factors for PIs and MDRPIs differ, preventive interventions should take this into account. This is a prospective cohort study aimed to determine the cumulative incidence of PIs and MDRPIs in critically ill patients and to identify corresponding risk factors. The study included 1418 patients who were admitted to the critical care medical center of a single university hospital in Tokyo, Japan, between 1 December 2019 and 31 August 2020. The Kaplan-Meier method was used to calculate the cumulative incidence of PIs and MDRPIs. Furthermore, the Cox proportional hazards model was used to analyse the predictors in both the PI and MDRPI incidence and non-incidence groups. Predictors were based on data from the 0th disease day. The cumulative incidence of PIs and MDRPIs was 4.6/1000 person-days and 3.6/1000 person-days, respectively. Multivariate analysis using the Cox proportional hazards model showed that common risk factors for the occurrence of PIs and MDRPIs were possession of PI on admission, higher blood lactate, blood purification therapy, and positional restriction. The risk factors for PIs only were diabetes mellitus, septic shock, and a lower serum albumin level, while the risk factors for MDRPIs only were the D-dimer level and extracorporeal membranous oxygenation treatment. Therefore, prophylactic interventions need to consider these different risk factors.

Pressure Injury Development, Mitigation, and Outcomes of Patients Proned for Acute Respiratory Distress Syndrome.

To describe trends and risk factors for pressure injuries (PIs) in adult critical care patients proned to alleviate acute respiratory distress syndrome secondary to COVID-19 and examine the effectiveness of products and strategies used to mitigate PIs. The authors conducted a retrospective chart review between April 9 and June 8, 2020. Demographic data were analyzed using descriptive statistics. Differences between groups with and without PIs were analyzed. Among 147 patients, significant PI risk factors included male sex (P = .019), high body mass index (>40 kg/m2; P = .020), low Braden Scale score (<12; P = .018), and low-dose vasopressor therapy (P = .020). Taping endotracheal tubes (ETTs) caused significantly fewer facial PIs than commercial ETT holders (P < .0001). Maximum prone duration/session was a significant risk factor for anterior PIs (P = .016), which dropped 71% with newer pressure redistribution products. d-Dimer greater than 3,200 μg/mL (P = .042) was a significant risk factor for sacrococcygeal PIs while supine. Mortality was 30%; significant risk factors included age older than 60 years (P = .005), Sequential Organ Failure Assessment score greater than 11 (P = .003), and comorbid congestive heart failure (P = .016). Taping the ETT, limiting the maximum duration of prone positioning to less than 32 hours, and frequent repositioning while supine may reduce the number of modifiable risk factors for PIs. Standardized methods for testing products for PI prevention will inform individualized patient care.

Risk Factors for Pressure Injuries in Adult Patients: A Narrative Synthesis.

Pressure injuries remain a serious health complication for patients and nursing staff. Evidence from the past decade has not been analysed through narrative synthesis yet. PubMed, Embase, CINAHL Complete, Web of Science, Cochrane Library, and other reviews/sources were screened. Risk of bias was evaluated using a slightly modified QUIPS tool. Risk factor domains were used to assign (non)statistically independent risk factors. Hence, 67 studies with 679,660 patients were included. In low to moderate risk of bias studies, non-blanchable erythema reliably predicted pressure injury stage 2. Factors influencing mechanical boundary conditions, e.g., higher interface pressure or BMI < 18.5, as well as factors affecting interindividual susceptibility (male sex, older age, anemia, hypoalbuminemia, diabetes, hypotension, low physical activity, existing pressure injuries) and treatment-related aspects, such as length of stay in intensive care units, were identified as possible risk factors for pressure injury development. Health care professionals’ evidence-based knowledge of above-mentioned risk factors is vital to ensure optimal prevention and/or treatment. Openly accessible risk factors, e.g., sex, age, BMI, pre-existing diabetes, and non-blanchable erythema, can serve as yellow flags for pressure injury development. Close communication concerning further risk factors, e.g., anemia, hypoalbuminemia, or low physical activity, may optimize prevention and/or treatment. Further high-quality evidence is warranted.