ArticleNursing research
Hospital-Acquired Pressure Injury: Risk-Adjusted Comparisons in an Integrated Healthcare Delivery System.
Article in Nursing research. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 86 citations in OpenAlex.
- Can an early mobilisation programme prevent hospital-acquired pressure injures in an intensive care unit?: A systematic review and meta-analysis.International wound journal · 2021Pooled it
- A systematic review of clinical practice guidelines and other best practice recommendations for pressure injury risk assessment in the United States.Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair SocietyPooled it
- Novel two-stage deep learning framework for automated pressure injury classification.BMJ health & care informatics · 2026Article
- VALENF-Instrument-Based Nursing Assessment and Early Occurrence of Hospital-Acquired Pressure Injuries and Falls Among Hospitalized Adults.Nursing reports (Pavia, Italy) · 2026Article
- The Role of EuroSCORE II in Predicting Postoperative Pressure Injuries in Cardiac Surgery Patients: A Cross-Sectional Study.Healthcare (Basel, Switzerland) · 2025Article
- Pressure Injury Prediction in Intensive Care Units Using Artificial Intelligence: A Scoping Review.Nursing reports (Pavia, Italy) · 2025Review
- Prevalence of pressure injury on the medical wards of public general hospitals in Kuwait: a national cross-sectional study.BMC health services research · 2024Article
- Risk predictions of hospital-acquired pressure injury in the intensive care unit based on a machine learning algorithm.International wound journal · 2023Article
- Sustaining a culture of safety and optimising patient outcomes while implementing zero harm programme: a 2-year project of the nursing services - SBAHC.BMJ open quality · 2023Article
- Systematic Review for Risks of Pressure Injury and Prediction Models Using Machine Learning Algorithms.Diagnostics (Basel, Switzerland) · 2023Review
- Association of ICU Admission and Outcomes in Sepsis and Acute Respiratory Failure.American journal of respiratory and critical care medicine · 2022Article
- Risk Factors for Pressure Injuries in Adult Patients: A Narrative Synthesis.International journal of environmental research and public health · 2022Review
- Clinical Coders' Perspectives on Pressure Injury Coding in Acute Care Services in Victoria, Australia.Frontiers in public health · 2022Article
- Modeling and prediction of pressure injury in hospitalized patients using artificial intelligence.BMC medical informatics and decision making · 2021Article
- Risk of readmissions, mortality, and hospital-acquired conditions across hospital-acquired pressure injury (HAPI) stages in a US National Hospital Discharge database.International wound journal · 2020Article
- Large sacral/buttocks ulcerations in the setting of coagulopathy: A case series establishing the skin as a target organ of significant damage and potential morbidity in patients with severe COVID-19.International wound journal · 2020Article
- Hydrosurgical Debridement Allows Effective Wound Bed Preparation of Pressure Injuries: A Prospective Case Series.Plastic and reconstructive surgery. Global open · 2020Article
- Pressure injury data in Australian acute care settings: A comparison of three data sets.International wound journal · 2020Article
- Patient education materials on pressure injury prevention in hospitals and health services in Victoria, Australia: Availability and content analysis.International wound journal · 2020Article
- Pressure Injury Prevention in COVID-19 Patients With Acute Respiratory Distress Syndrome.Frontiers in medicine · 2020Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 2 countries.
Funding
Abstract
backgroundAlthough healthcare organizations have decreased hospital-acquired pressure injury (HAPI) rates, HAPIs are not eliminated, driving further examination in both nursing and health services research.
objectiveThe objective was to describe HAPI incidence, risk factors, and risk-adjusted hospital variation within a California integrated healthcare system.
methodsInpatient episodes were included in this retrospective cohort if patients were hospitalized between January 1, 2013, and June 30, 2015. The primary outcome was development of a HAPI over time. Predictors included cited HAPI risk factors in addition to incorporation of a longitudinal comorbidity burden (Comorbidity Point Score, Version 2 [COPS2]), a severity-of-illness score (Laboratory-Based Acute Physiology Score, Version 2 [LAPS2]), and the Braden Scale for Predicting Pressure Ulcer Risk.
resultsAnalyses included HAPI inpatient episodes (n = 1661) and non-HAPI episodes (n = 726,605). HAPI incidence was 0.57 per 1,000 patient days (95% CI [0.019, 3.805]) and 0.2% of episodes. A multivariate Cox proportional hazards model showed significant (p < .001) hazard ratios (HRs) for the change from the 25th to the 75th percentile for age (HR = 1.36, 95% CI [1.25, 1.45]), higher COPS2 scores (HR = 1.10, 95% CI [1.04, 1.16]), and higher LAPS2 scores (HR = 1.38, 95% CI [1.28, 1.50]). Female gender, an emergency room admission for a medical reason, and higher Braden scores showed significant protective HRs (HR < 1.00, p < .001). After risk adjustment, significant variation remained among the 35 hospitals. DISCUSSION: Results prompt the consideration of age, severity of illness (LAPS2), comorbidity indexes (COPS2), and the Braden score as important predictors for HAPI risk. HAPI rates may be low; however, because of significant individual site variation, HAPIs remain an area to explore through both research and quality improvement initiatives.
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Registered trials
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