Validation of a Model for Predicting Pressure Injury Risk in Patients With Vascular Diseases.

PURPOSE

The purpose of this study was to validate a 10-factor model of risk factors for hospital-acquired pressure injury (HAPI) risk in patients with vascular disease.

SUBJECTS AND SETTING

Medical reviews identified 800 patients from a 1063 admissions to a 1400 bed quarternary care hospital in the midwestern United States.

DESIGN

Retrospective review of medical records.

METHODS

Medical records of consecutive patients treated during an 18-month period on a medical-surgical vascular progressive care unit were reviewed. Ten previously identified risk factors for HAPI-(1) lower right ankle-brachial index, (2) low Braden Scale for Pressure Sore Risk score, (3) cared for in intensive care unit, (4) low serum hematocrit values, (4) elevated serum hematocrit levels (5) female gender, (6) nonwhite individual, (7) atherosclerosis, (8) diabetes mellitus, (9) elevated blood urea nitrogen levels, and (10) high body mass index-were compared to determine their ability to predict development of HAPI. Logistic regression model was used to validate the model.

RESULTS

One hundred forty-six (16.1%) out of 800 patients developed an HAPI. The 10-factor risk model produced a concordance index of predicted to actual risk of 0.851, and the likelihood of developing an HAPI based on the model was significant (P < .001).

CONCLUSIONS

A 10-factor model of HAPI risk was developed for patients with vascular disease. Routine assessment of risk factors is crucial in planning individualized interventions to diminish the risk of HAPI occurrences.