The prediction model for intraoperatively acquired pressure injuries in orthopedics based on the new risk factors: a real-world prospective observational, cross-sectional study

Abstract

Introduction: Orthopedic patients are at high risk for intraoperatively acquired pressure injuries (IAPI), which cause a serious issue and lead to high-expense burden in patient care. However, there are currently no clinically available scales or models to assess IAPI associated with orthopedic surgery.Methods: In this real-world, prospective observational, cross-sectional study, we identified pressure injuries (PI)-related risk factors using a systematic review approach and clinical practice experience. We then prepared a real-world cohort to identify and confirm risk factors using multiple modalities. We successfully identified new risk factors while constructing a predictive model for PI in orthopedic surgery.Results: We included 28 orthopedic intraoperative PI risk factors from previous studies and clinical practice. A total of 422 real-world cases were also included, and three independent risk factors—preoperative limb activity, intraoperative wetting of the compressed tissue, and duration of surgery—were successfully identified using chi-squared tests and logistic regression. Finally, the three independent risk factors were successfully used to construct a nomogram clinical prediction model with good predictive validity (area under the ROC curve = 0.77), which is expected to benefit clinical patients.Conclusion: In conclusion, we successfully identified new independent risk factors for IAPI-related injury in orthopedic patients and developed a clinical prediction model to serve as an important complement to existing scales and provide additional benefits to patients. Our study also suggests that a single measure is not sufficient for the prevention of IAPI in orthopedic surgery patients and that a combination of measures may be required for the effective prevention of IAPI.

Explore the effect of pressure and time of compression on the risk of intraoperatively acquired pressure injury based on theoretical framework: A prospective study

“…The results showed that the occurrence of PI increased the risk of hospital death by 2.81 times, the risk of death within 30 days of discharge by 1.69 times and the rate of hospitalization within 30 days by 1.33 times 3 . Pressure injuries that develop in the operating room (OR) are termed intraoperatively acquired pressure injuries (IAPIs) 4 . They develop on previously healthy skin and deeper tissues when patients undergo surgery of several hours' duration.…”