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Nomogram for Risk Assessment of Pressure Injury in Hospitalized Patients: A Retrospective Case-control Study.

Hongyan Zhang1, Qian Su2, Lian Chen3,4

  • 1Department of Nursing, Gansu Provincial Hospital, Lanzhou City, Gansu Province, China.

Advances in Skin & Wound Care
|January 15, 2026
PubMed
Summary

A new nomogram model accurately predicts pressure injury (PI) risk in hospitalized patients. This visual tool aids healthcare professionals in early risk assessment and management of hospital-acquired pressure injuries (HAPIs).

Keywords:
nomogrampressure injuryrisk assessment modelrisk factor

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Area of Science:

  • Clinical Nursing Research
  • Patient Safety
  • Predictive Modeling in Healthcare

Background:

  • Pressure injuries (PIs) pose a significant risk to hospitalized patients.
  • Effective risk assessment tools are crucial for preventing hospital-acquired pressure injuries (HAPIs).
  • Existing assessment methods may require enhancement for improved accuracy and usability.

Purpose of the Study:

  • To develop and validate a nomogram model for pressure injury (PI) risk assessment in hospitalized patients.
  • To create a visual tool for hospital-acquired pressure injury (HAPI) risk assessment and management.

Main Methods:

  • Retrospective case-control study involving 973 patients across two hospitals.
  • Patients were divided into development (n=682) and validation (n=291) cohorts.
  • Logistic regression identified PI risk factors; model validation included C-index, ROC curve analysis, calibration curves, and decision curve analysis (DCA).

Main Results:

  • A 9-variable nomogram model was developed, including age, hospital stay length, alcohol consumption, self-care ability, bowel status changes, Braden score, nasogastric tube, sedative analgesics, and diuretic drugs.
  • The nomogram demonstrated strong predictive performance with an AUC of 0.862 in the development cohort and 0.871 in the validation cohort.
  • Calibration curves and DCA confirmed good consistency and clinical utility of the nomogram for risk assessment.

Conclusions:

  • A high-performance nomogram model accurately assesses pressure injury risk in hospitalized patients.
  • This visual tool assists nursing staff and caregivers in early risk assessment, intervention, and management of HAPIs.
  • The nomogram offers a reliable and practical solution for improving patient safety and reducing HAPI incidence.