Risk Profiles in Hospitalized Adults Based on Functional Capacity, Pressure Injury Risk, and Fall Risk: A Cluster and...

Patient safety is a global priority, as adverse events represent the 14th leading cause of morbidity and mortality worldwide. Among the most common complications in hospitalized adults are functional decline, pressure injuries, and falls, all of which increase hospital stays, healthcare costs, and mortality. Although these risks are typically assessed independently, their interaction has been scarcely explored, and the identification of integrated patient risk profiles could better guide nursing care.

To establish profiles of adult inpatients based simultaneously on their level of functional capacity, risk of pressure injuries, and risk of falls.

Cross-sectional observational study.

A total of 2.666 patients were admitted to adult inpatient units in a Spanish hospital.

Data from the Barthel, Braden, and Downton scales collected within 24 h of admission were analyzed. A hierarchical cluster analysis followed by the k-means method was used to classify patients. Relationship between profiles and clinical variables were explored through multiple correspondence analysis, and predictors for each profile were identified using multinomial logistic regression.

Three patient profiles were identified: profile 1 (low risk), minor dependency, low risk of pressure injuries and falls (68.5%); profile 2 (moderate risk), moderate dependency and intermediate risk (15.4%); and profile 3 (high risk), severe dependency with high risk of pressure injuries and falls (16.1%). Older age, female sex, and higher comorbidity were significantly associated with higher-risk profiles (p < 0.001).

Hospitalized adults can be reliably classified into risk profiles based on functional capacity and the risk of pressure injuries and falls.

The identification of combined risk profiles may potentially guide nursing strategies to enhance patient safety, support individualized care planning, and contribute to optimizing resource distribution in hospital settings.

Loss of functional capacity, pressure injuries, and falls are key nursing-sensitive indicators of care quality. Profile-based stratification offers a new framework for personalized, data-driven, and safety-oriented nursing care.

The identification of integrated risk profiles based on functional capacity, pressure injury risk, and fall risk may support more comprehensive nursing assessment in hospitalized adults. These profiles may help inform care prioritization, facilitate early identification of vulnerable patients, and contribute to more efficient allocation of nursing resources. Incorporating multidimensional risk stratification into clinical practice may enhance coordinated and patient-centered care planning.