Exploratory Analysis of Factors Associated With Pressure Injuries in Surgical Patients Assessed With the ELPO Scale.
Manuela de Mendonça Figueirêdo Coelho, Beatriz Alves de Olivera, Thalia Alves Chagas Menezes and 6 others
PMID 42533409WHAT IT FOUND
In 2698 surgical patients, lateral positioning and thermal mattress use were linked to more pressure injuries, while protective cover use was linked to fewer.
The prediction models were not ready to guide care.
Key findings
01Pressure injuries were documented in 79 of 2698 surgical patients (2.9%).
02In adjusted analysis, male sex, lateral position and thermal mattress use were associated with higher odds of pressure injury, while cover use and surgery lasting at least 2 hours were associated with lower odds.
03The models were exploratory and not ready for clinical prediction; logistic regression and Random Forest had AUC values of 0.62 and 0.61.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 79 of 2698 patients had a pressure injury, so the study had low power for many subgroup and preventive-resource comparisons. The data came from one hospital and from records created for care, not for research, so missed documentation or local practice patterns could affect the results. Patients were not randomly assigned to cushions, covers, dressings or thermal mattresses, so the associations may reflect differences in patient risk or care rather than the effect of the resource. The surgery time finding was unexpected and may reflect confounding by case mix, documentation or more preventive vigilance during longer procedures. Some protective-resource categories had very few exposed patients, making estimates unstable. The prediction models were explored internally but not externally validated, and their discriminative performance was limited.
Declared interests
Funding was provided by the Institutional Program for Scientific Initiation Scholarships of the Federal University of Ceará.
The easy way to misread this
Do not read the lower odds with cover use as proof that protective covers prevent pressure injuries. The study was observational, resources were not randomly allocated, and the authors say the association may reflect residual confounding or more comprehensive preventive care.