Patterns of Co-Occurring Pressure Injuries: A Data-Driven Study Using Real-World Clinical Records

Area of Science:

• Clinical Informatics
• Wound Care
• Epidemiology

Background:

• Pressure injuries (PrIs) are a significant healthcare concern.
• Understanding the patterns and risk factors of co-occurring PrIs is crucial for effective patient management.
• Real-world clinical data offers valuable insights into PrI prevalence and associated conditions.

Purpose of the Study:

• To investigate the prevalence, patterns, and risk factors of co-occurring pressure injuries (PrIs) in a large healthcare system.
• To develop and validate an electronic health record (EHR)-based phenotype for identifying patients with co-occurring PrIs.
• To identify specific patient characteristics and injury types associated with the presence of multiple PrIs.

Main Methods:

• Retrospective cohort study analyzing EHR data from adult patients with PrIs between 2015 and 2023.
• Development and validation of an EHR-based phenotype to accurately identify co-occurring PrIs.
• Utilized univariate analyses and binary logistic regression to determine risk factors for co-occurring PrIs.

Main Results:

• Out of 18,195 patients with PrIs, 4,415 (24.3%) had co-occurring PrIs.
• The validated EHR phenotype demonstrated high accuracy (0.96).
• Severe PrIs (OR 3.47), Black or African American race (OR 1.45), and spinal cord injury (OR 1.32) were significantly associated with co-occurring PrIs.

Conclusions:

• Co-occurring PrIs are common and strongly associated with increased injury severity.
• A direct relationship exists between the number of PrIs and the severity of the injuries.
• Findings highlight the need for targeted risk assessment and prevention strategies for co-occurring PrIs.