{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T09:44:43Z","timestamp":1773827083501,"version":"3.50.1"},"reference-count":37,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,1,6]],"date-time":"2021-01-06T00:00:00Z","timestamp":1609891200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,1,6]],"date-time":"2021-01-06T00:00:00Z","timestamp":1609891200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009320","name":"American Association of Critical-Care Nurses","doi-asserted-by":"publisher","award":["2019 Critical Care Grant"],"award-info":[{"award-number":["2019 Critical Care Grant"]}],"id":[{"id":"10.13039\/100009320","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Inform Decis Mak"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Hospital-acquired pressure injuries (HAPrIs) are areas of damage to the skin occurring among 5\u201310% of surgical intensive care unit (ICU) patients. HAPrIs are mostly preventable; however, prevention may require measures not feasible for every patient because of the cost or intensity of nursing care. Therefore, recommended standards of practice include HAPrI risk assessment at routine intervals. However, no HAPrI risk-prediction tools demonstrate adequate predictive validity in the ICU population. The purpose of the current study was to develop and compare models predicting HAPrIs among surgical ICU patients using electronic health record (EHR) data.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>In this retrospective cohort study, we obtained data for patients admitted to the surgical ICU or cardiovascular surgical ICU between 2014 and 2018 via query of our institution's EHR. We developed predictive models utilizing three sets of variables: (1) variables obtained during routine care\u2009+\u2009the Braden Scale (a pressure-injury risk-assessment scale); (2) routine care only; and (3) a parsimonious set of five routine-care variables chosen based on availability from an EHR and data warehouse perspective. Aiming to select the best model for predicting HAPrIs, we split each data set into standard 80:20 train:test sets and applied five classification algorithms. We performed this process on each of the three data sets, evaluating model performance based on continuous performance on the receiver operating characteristic curve and the F<jats:sub>1<\/jats:sub> score.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Among 5,101 patients included in analysis, 333 (6.5%) developed a HAPrI. F<jats:sub>1<\/jats:sub> scores of the five classification algorithms proved to be a valuable evaluation metric for model performance considering the class imbalance. Models developed with the parsimonious data set had comparable F<jats:sub>1<\/jats:sub> scores to those developed with the larger set of predictor variables.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Results from this study show the feasibility of using EHR data for accurately predicting HAPrIs and that good performance can be found with a small group of easily accessible predictor variables. Future study is needed to test the models in an external sample.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12911-020-01371-z","type":"journal-article","created":{"date-parts":[[2021,1,6]],"date-time":"2021-01-06T21:03:31Z","timestamp":1609967011000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Hospital acquired pressure injury prediction in surgical critical care patients"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6491-1311","authenticated-orcid":false,"given":"Jenny","family":"Alderden","sequence":"first","affiliation":[]},{"given":"Kathryn P.","family":"Drake","sequence":"additional","affiliation":[]},{"given":"Andrew","family":"Wilson","sequence":"additional","affiliation":[]},{"given":"Jonathan","family":"Dimas","sequence":"additional","affiliation":[]},{"given":"Mollie R.","family":"Cummins","sequence":"additional","affiliation":[]},{"given":"Tracey L.","family":"Yap","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2021,1,6]]},"reference":[{"issue":"3","key":"1371_CR1","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1111\/iwj.13071","volume":"16","author":"WV Padula","year":"2019","unstructured":"Padula WV, Delarmente BA. The national cost of hospital-acquired pressure injuries in the United States. Int Wound J. 2019;16(3):634\u201340.","journal-title":"Int Wound J"},{"key":"1371_CR2","unstructured":"Centers for Medicare & Medicaid Services. Eliminating serious, preventable, and costly medical errors\u2014never events. 2006. https:\/\/www.cms.gov\/newsroom\/fact-sheets\/eliminating-serious-preventable-and-costly-medical-errors-never-events. Accessed 16 Apr 2020."},{"key":"1371_CR3","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.ijnurstu.2017.03.012","volume":"71","author":"J Alderden","year":"2017","unstructured":"Alderden J, Rondinelli J, Pepper G, Cummins M, Whitney J. Risk factors for pressure injuries among critical care patients: a systematic review. Int J Nurs Stud. 2017;71:97\u2013114.","journal-title":"Int J Nurs Stud"},{"issue":"9","key":"1371_CR4","first-page":"234","volume":"24","author":"HL Chen","year":"2012","unstructured":"Chen HL, Chen XY, Wu J. The incidence of pressure ulcers in surgical patients of the last 5 years: a systematic review. Wounds. 2012;24(9):234\u201341.","journal-title":"Wounds"},{"key":"1371_CR5","unstructured":"Emily Haesler, editor. European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel, and Pan Pacific Injury Alliance. Prevention and treatment of pressure ulcers\/injuries: clinical practice guideline. The international guideline. EPUAP\/NPIAP\/PPPIA; 2019."},{"key":"1371_CR6","unstructured":"Agency for Healthcare Research and Quality. Preventing pressure ulcers in hospitals. 2014. https:\/\/www.ahrq.gov\/professionals\/systems\/hospital\/pressureulcertoolkit\/putool1.html. Accessed 12 Apr 2020."},{"issue":"4","key":"1371_CR7","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1097\/00006199-198707000-00002","volume":"36","author":"N Bergstrom","year":"1987","unstructured":"Bergstrom N, Braden BJ, Laguzza A, Holman V. The Braden Scale for predicting pressure sore risk. 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The IRB approved a waiver of informed consent per the United States Department of Health and Human Services guideline 21 CFR 46.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All authors consent to publication.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"12"}}