Risk Factors Associated With Hospital-Acquired Pressure Injuries in Patients Undergoing Surgical Hip Fracture Repair.

Abstract

Purpose: The purpose of this study was to identify independent risk factors associated with an increased risk of new hospital-acquired pressure injury (HAPI) formation in surgical patients with a hip fracture.

Design: Descriptive, correlational study.

Subjects and setting: The sample comprised 14 523 patients with a hip fracture who underwent a surgical procedure in 2019. Data were acquired from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). The ACS-NSQIP contains data from ambulatory surgery departments and acute care hospitals within the United States.

Methods: Descriptive and regression analyses were conducted, including bivariate analysis and multiple logistic regression, to identify independent risk factors for HAPI formation. The outcome measure was HAPI formation identified in the data file. Independent variables included sociodemographic characteristics, preoperative health conditions and functional abilities, preoperative laboratory values, and perioperative factors.

Results: Among 14 523 patients, 628 (4.3%) developed at least 1 HAPI. Age greater than 70 years (OR = 1.488, P = .010), BMI less than 18.5 kg/m2 (OR = 1.347, P = .047), weight loss more than 10% within 6 months before surgery (OR = 2.775, P < .001), preoperative use of a mobility aid (OR = 1.833, P < .001), insulin dependence in diabetic patients (OR = 1.753, P < .001), preoperative blood urea nitrogen level greater than 24 mg/dL (OR = 1.634, P < .001), and duration from hospital admission to surgery longer than 1 day (OR = 1.400, P = .006) were identified as independent risk factors for HAPI formation.

Conclusions: This study highlights the risk factors associated with new HAPI formation in surgical hip fracture patients. Nurses can use these findings to incorporate pressure injury risk factor assessment into routine care planning.