Analysis of Characteristics Associated With Advanced-Stage Pressure Injury Classification Among Korean Hospitalised...

This study aimed to identify demographic and clinical factors associated with advanced-stage pressure injury (PI) classification among hospitalised patients diagnosed with PIs using the Health Insurance Review and Assessment Service (HIRA) patient sample database.

This secondary data analysis was approved by the Institutional Review Board of K University (IRB No. 2020-0266). Public data were analysed using SAS Enterprise Guide on a designated computer, and all procedures complied with data security and confidentiality requirements.

A secondary analysis was conducted using the HIRA patient sample database from 2017 to 2019. Patients diagnosed with pressure injuries were classified into a mild-stage group (Stages 1-2) and an advanced-stage group (Stages 3-4). Multivariable logistic regression analysis was performed to identify factors associated with advanced-stage pressure injury classification (Stage 3-4 vs. Stage 1-2), and odds ratios (ORs) with 95% confidence intervals (CIs) were estimated.

Male patients had higher odds of being classified as having advanced-stage pressure injuries than female patients (OR = 1.25). The odds of advanced-stage pressure injury classification increased by 1.02 for each one-year increase in age and by 1.02 for each additional day of hospitalisation. Patients with urinary incontinence and malnutrition had 3.32-fold and 2.76-fold higher odds, respectively, of being classified as having advanced-stage pressure injuries than those without these conditions (p < 0.001).

Sex, age, length of hospital stay and specific comorbidities were significantly associated with advanced-stage pressure injury classification among hospitalised patients with pressure injuries. Urinary incontinence and malnutrition showed particularly strong associations with advanced-stage classification. These findings may support the early identification of patients who are more likely to present with advanced-stage pressure injuries and inform targeted assessment and management strategies in clinical practice. Because this study was based on cross-sectional administrative claims data, the findings should be interpreted as associations with advanced-stage classification rather than evidence of temporal progression or causation.

This study utilised secondary administrative data from a nationally representative sample provided by the Health Insurance Review and Assessment Service (2017-2019). No patients or members of the public were directly involved in the design or conduct of this study because the analyses were based on de-identified administrative claims data.