Risk factors for pressure injuries in critical care patients: an updated systematic review

Area of Science:

• Critical Care Medicine
• Nursing Research
• Patient Safety

Background:

• Pressure injuries (PI) pose a significant threat to critically ill patients.
• Previous systematic reviews have identified several risk factors for PI development.
• An updated review is necessary to incorporate recent evidence and refine understanding of PI risk factors.

Purpose of the Study:

• To systematically review and update the evidence on independent risk factors for pressure injury development in critically ill patients.
• To identify new and reinforce existing risk factors based on studies published between January 2017 and December 2024.
• To inform clinical practice and future research directions for PI prevention.

Main Methods:

• Systematic review methodology was employed, searching five major databases.
• Studies published from January 2017 to December 2024 were included.
• Data extraction and quality assessment were performed independently by investigators, followed by narrative synthesis.

Main Results:

• Thirty-three studies were included, with 15 new since the prior review.
• Consistently identified risk factors include older age, limited mobility, impaired perfusion, vasopressor use, and longer intensive care unit (ICU) length of stay.
• Diabetes emerged as a notable risk factor, though evidence for nutrition and skin status measurement remains inconsistent.

Conclusions:

• The updated evidence reinforces age, mobility, perfusion, and vasopressor use as critical risk factors for pressure injuries.
• Length of stay and diabetes are identified as additional significant contributors.
• Future research should focus on standardizing measurements and exploring the interplay of multiple risk factors.