Perioperative Risk Factors of Postoperative Pressure Injuries in Patients after Surgical Hematoma Evacuation of Intracranial Hemorrhage: A Retrospective Cohort Study.

Abstract

Objective: To identify the incidence and perioperative risk factors of postoperative pressure injuries (PIs) in patients with intracranial hemorrhage who had surgical evacuation of hematoma.

Methods: This retrospective cohort study was conducted at a tertiary care university hospital. Researchers collected medical record data from April 2010 to March 2020 and conducted backward selection in multiple logistic regression.

Results: Of the 386 patients identified, 103 (26.7%) developed postoperative PIs. The most common site of PI was the coccyx (n = 56; 38.9%). More than half of the patients had stage 2 PIs, and 43 (41.7%) developed PIs 14 or more days after surgery. Three variables were associated with an increased risk of postoperative PI: older age (P = .025), receiving a packed red blood cell transfusion while in the ICU (P = .004), and staying in the ICU for more than 7 days (P < .001).

Conclusions: The present findings indicate that risk factors for postoperative PIs include older age, requiring a blood transfusion, and longer ICU stays, which may increase nursing workload regardless of surgery type. Future research on postoperative PIs in patients undergoing neurosurgery should consider additional ICU work environment factors, including nurse-to-patient ratio and immobility-related factors such as duration of medical device use. Further, international comparisons of risk factors for postoperative PIs among patients undergoing neurosurgery are needed.