Prognostic factors of pressure injury: a scoping review

This scoping review aimed to comprehensively map prognostic factors of pressure injuries and to synthesize reported evidence on their predictive performance to identify research gaps.

Studies published between January 2001 and April 2025 were identified from databases using the PRISMA-ScR methodology. Eligible articles investigated the prognostic factors for pressure injuries.

A total of 54 studies were included. Outcome definitions varied and included complete healing, time to heal, changes in wound area or depth, and assessment tool scores. Predictive performance was evaluated in 18 studies; however, one reported an area under the curve of ≥0.9. Prognostic factors were categorized according to their acquisition methods: Category A, clinical chart data or questionnaires (age, mobility, and pressure injury depth and size were reported most frequently); Category B, medical imaging (thermographic temperature differences and ultrasonographic findings were reported most frequently); and Category C, biomarkers (biofilm was most frequently reported). One study showed that combining factors obtained through different methods-none individually associated with outcomes-yielded a statistically significant prognostic value. Nineteen studies distinguished between superficial and deep-pressure injuries.

This review provides a comprehensive overview of the prognostic factors and predictive performance for pressure injuries, highlighting key research gaps. Prognosis was broadly defined, underscoring the need for standardization, although prognostic factors could still be mapped by acquisition method. Predictive performance was generally limited, highlighting the need for improvement. Stratifying prognostic factors by wound characteristics, such as depth, and integrating those from multiple acquisition methods may help address these gaps.