{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T10:11:48Z","timestamp":1770977508286,"version":"3.50.1"},"reference-count":19,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T00:00:00Z","timestamp":1720742400000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["International Wound Journal"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>This study aimed to improve the predictive accuracy of the Braden assessment for pressure injury risk in skilled nursing facilities (SNFs) by incorporating real\u2010world data and training a survival model. A comprehensive analysis of 126\u2009384 SNF stays and 62\u2009253 in\u2010house pressure injuries was conducted using a large calibrated wound database. This study employed a time\u2010varying Cox Proportional Hazards model, focusing on variations in Braden scores, demographic data and the history of pressure injuries. Feature selection was executed through a forward\u2010backward process to identify significant predictive factors. The study found that sensory and moisture Braden subscores were minimally contributive and were consequently discarded. The most significant predictors of increased pressure injury risk were identified as a recent (within 21\u2009days) decrease in Braden score, low subscores in nutrition, friction and activity, and a history of pressure injuries. The model demonstrated a 10.4% increase in predictive accuracy compared with traditional Braden scores, indicating a significant improvement. The study suggests that disaggregating Braden scores and incorporating detailed wound histories and demographic data can substantially enhance the accuracy of pressure injury risk assessments in SNFs. This approach aligns with the evolving trend towards more personalized and detailed patient care. These findings propose a new direction in pressure injury risk assessment, potentially leading to more effective and individualized care strategies in SNFs. The study highlights the value of large\u2010scale data in wound care, suggesting its potential to enhance quantitative approaches for pressure injury risk assessment and supporting more accurate, data\u2010driven clinical decision\u2010making.<\/jats:p>","DOI":"10.1111\/iwj.70000","type":"journal-article","created":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T12:05:13Z","timestamp":1720785913000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Improving pressure injury risk assessment using real\u2010world data from skilled nursing facilities: A cohort study"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9021-4747","authenticated-orcid":false,"given":"Matthew Oliver","family":"Wynn","sequence":"first","affiliation":[{"name":"School of Health and Society University of Salford  Salford UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucas","family":"Goldstone","sequence":"additional","affiliation":[{"name":"Swift Medical Inc  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rishabh","family":"Gupta","sequence":"additional","affiliation":[{"name":"Swift Medical Inc  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin","family":"Allport","sequence":"additional","affiliation":[{"name":"Swift Medical Inc  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert D. J.","family":"Fraser","sequence":"additional","affiliation":[{"name":"Swift Medical Inc  Toronto Ontario Canada"},{"name":"Arthur Labatt Family School of Nursing Western University  London Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,7,12]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Prevention and Treatment of Pressure Ulcers\/Injuries: Clinical Practice Guideline","author":"EPUAP\/NPIAP\/PPPIA","year":"2019"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijnurstu.2023.104605"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010021\u201001188\u20104"},{"issue":"3","key":"e_1_2_10_5_1","first-page":"26","article-title":"Calculating the risk: reflections on the Norton Scale","volume":"2","author":"Norton D","year":"1988","journal-title":"Decubitus"},{"issue":"3","key":"e_1_2_10_6_1","first-page":"34","article-title":"Clinical utility of the Braden Scale for predicting tissue sore risk","volume":"2","author":"Braden BJ","year":"1988","journal-title":"Decubitus"},{"issue":"1","key":"e_1_2_10_7_1","first-page":"8","article-title":"The Waterlow card for the prevention and management of pressure sores: towards a pocket policy","volume":"6","author":"Waterlow J","year":"1988","journal-title":"Care Sci Pract"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.iccn.2024.103686"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006471.pub4"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jan.12444"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.16154"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.16987"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics13172739"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1155\/2021\/1302811"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare10112330"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X18801312"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtv.2020.05.001"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12911\u2010021\u201001608\u20105"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.25270\/wnds\/23089"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/2516043520914215"}],"container-title":["International Wound Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/iwj.70000","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,26]],"date-time":"2024-07-26T03:08:32Z","timestamp":1721963312000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/iwj.70000"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7]]},"references-count":19,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024,7]]}},"alternative-id":["10.1111\/iwj.70000"],"URL":"https:\/\/doi.org\/10.1111\/iwj.70000","archive":["Portico"],"relation":{},"ISSN":["1742-4801","1742-481X"],"issn-type":[{"value":"1742-4801","type":"print"},{"value":"1742-481X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7]]},"assertion":[{"value":"2024-04-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-12","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70000"}}