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

Abstract

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.

Biomarkers and clinical features associated with pressure injury among geriatric patients

“…Risk factors associated with PI include older age, low body mass index <18.5, low albumin and hemoglobin levels and high C-reactive protein (CRP) levels [9,10]. Recently, C-reactive protein to albumin ratio (CAR) was a novel inflammatory marker in various infectious diseases and a mortality indicator in different cancers [11].…”

“…Recently, C-reactive protein to albumin ratio (CAR) was a novel inflammatory marker in various infectious diseases and a mortality indicator in different cancers [11]. Evidence-based knowledge about factors associated with PI is crucial to mitigate the occurrence of PI in healthcare settings [9]. The study aims to identify biomarkers and clinical features associated with PI and assess the potential role of CAR in PI among geriatric patients.…”

Development and validation of a nomogram for predicting the risk of pressure injury in adult patients undergoing abdominal surgery

“…Patients undergoing surgery are unable to relieve local tissue pressure by frequently changing the surgical position intraoperatively [ 8 ]. Meanwhile, patients who undergo surgery often need to be admitted to the ICU for postoperative care [ 9 ]. These may be risk factors for the incidence of PI.…”

Principais fatores de risco associados à lesão por pressão em região do calcâneo: uma revisão sistemática

“…Isso pode ser devido a sedação, paralisia, trauma, fragilidade e até mesmo abuso ou negligência. Se o paciente tiver uma sensação prejudicada de qualquer causa, por exemplo, lesão da medula espinhal, distúrbios neurológicos crônicos ou neuropatia periférica, as respostas aos estímulos nocivos são interrompidas e a pressão externa passa despercebida (Chung et al, 2022).…”

“…A pele úmida é mais suscetível e, portanto, as incontinências fecal e urinária são consideradas fatores de risco. Na situação de doença crítica, instabilidade hemodinâmica grave e um estado catabólico podem levar ao desenvolvimento mais rápido de isquemia tecidual (Chung et al, 2022). Research, Society and Development, v. 11, n. 13, e76111335158, 2022 (CC BY 4.0) | ISSN 2525-3409 | DOI: http://dx.doi.org/10.33448/rsd-v11i13.35158…”