Perioperative Pressure Injuries: A Descriptive Study of Patient Characteristics

The perioperative setting presents unique challenges that contribute to the development of pressure injury (PI). In this study, the authors explore the incidence and baseline characteristics of perioperative patients (adult, inpatient, and surgical patient population with at least 3 days' hospital stay) who undergo surgery and have PI outcomes.

This descriptive retrospective study was conducted using electronic medical record data of 55,270 patients from an academic health care system. Differences in baseline characteristics between patients with versus without PI were examined using the Fisher exact test, χ 2 tests, and t tests.

The incidence of perioperative pressure injury (PPI) was 0.5%. Of the PPI group, 65.7% developed PPI after cardiovascular surgery. The most prevalent PPI stage was unstageable, followed by Stage 2 and deep tissue injury. The most common locations for PPI were the back, followed by the buttocks and heels. The PPI group was older and had a higher average comorbidity score ( P <.001). Comorbidity differences of those with and without PPI were observed in congestive heart failure (28.1% vs. 15.2%, P <.001), diabetes (28.5% vs. 19.2%, P <.001), renal disease (27.7% vs. 18.8%, P <.001), and severe liver disease (8.0% vs. 3.4%, P <.001). There were no differences in race, body mass index, or history of tobacco use between the PPI group and the non-PPI group.

This study identified that cardiovascular surgery remains a high risk for PPI in perioperative patients. Among the demographic characteristics, race is not a sufficient category for identifying risk for PPI as it lacks the accuracy in skin tone measurement.