Analysis of Characteristics Associated With Advanced-Stage Pressure Injury Classification Among Korean Hospitalised Patients: A Secondary Data Analysis.
Minkyung Gu, Ye Seul Choi, Sohyune Sok
PMID 42447083WHAT IT FOUND
Among hospitalised patients with pressure injuries, urinary incontinence, malnutrition, older age, male sex and longer stay were linked to advanced-stage classification; fall history and Alzheimer's disease were linked to mild-stage classification.
Key findings
01Urinary incontinence was associated with 3.32-fold higher odds of advanced-stage pressure injury classification, and malnutrition was associated with 2.76-fold higher odds.
02Male sex, each additional year of age and each additional hospital day were associated with higher odds of advanced-stage pressure injury classification (OR 1.25, 1.02 and 1.02).
03Alzheimer's disease and a history of falls were associated with lower odds of advanced-stage pressure injury classification (OR 0.93 and 0.48), but fall history was rare (74 patients, 0.2%) and requires cautious interpretation.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was cross-sectional claims data, so the associations do not show that any factor caused advanced-stage pressure injury; length of stay could be a consequence rather than a cause. Diagnosis and stage were taken from reimbursement coding, so coding errors, undercoding and misclassification may be present. The database lacked clinical measures such as Braden Scale scores, nutritional biomarkers, functional status, mobility and detailed wound characteristics, so unmeasured confounding cannot be excluded. The regression analysed only classifiable Stages 1-4, while descriptive analyses included 544,643 records; unstageable or unclassified cases were excluded. The lower odds associated with fall history rested on only 74 patients (0.2%) and should not be read as a protective finding. The study included only patients already diagnosed with pressure injuries and had no comparison group without pressure injuries.
Declared interests
The authors reported no funding to disclose and declared no conflicts of interest.
The easy way to misread this
Do not read these odds ratios as proof that incontinence, malnutrition, longer hospital stay or any nursing action caused or prevented advanced-stage pressure injury. This was a cross-sectional analysis of reimbursement claims data without clinical severity measures, so reverse causation and unmeasured confounding remain possible.