{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:19:54Z","timestamp":1792189194290,"version":"4.4.0"},"reference-count":98,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,1,11]],"date-time":"2022-01-11T00:00:00Z","timestamp":1641859200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006360","name":"Federal Ministry for Economic Affairs and Energy","doi-asserted-by":"publisher","award":["ZF4698801TS9"],"award-info":[{"award-number":["ZF4698801TS9"]}],"id":[{"id":"10.13039\/501100006360","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Pressure injuries remain a serious health complication for patients and nursing staff. Evidence from the past decade has not been analysed through narrative synthesis yet. PubMed, Embase, CINAHL Complete, Web of Science, Cochrane Library, and other reviews\/sources were screened. Risk of bias was evaluated using a slightly modified QUIPS tool. Risk factor domains were used to assign (non)statistically independent risk factors. Hence, 67 studies with 679,660 patients were included. In low to moderate risk of bias studies, non-blanchable erythema reliably predicted pressure injury stage 2. Factors influencing mechanical boundary conditions, e.g., higher interface pressure or BMI &lt; 18.5, as well as factors affecting interindividual susceptibility (male sex, older age, anemia, hypoalbuminemia, diabetes, hypotension, low physical activity, existing pressure injuries) and treatment-related aspects, such as length of stay in intensive care units, were identified as possible risk factors for pressure injury development. Health care professionals\u2019 evidence-based knowledge of above-mentioned risk factors is vital to ensure optimal prevention and\/or treatment. Openly accessible risk factors, e.g., sex, age, BMI, pre-existing diabetes, and non-blanchable erythema, can serve as yellow flags for pressure injury development. Close communication concerning further risk factors, e.g., anemia, hypoalbuminemia, or low physical activity, may optimize prevention and\/or treatment. Further high-quality evidence is warranted.<\/jats:p>","DOI":"10.3390\/ijerph19020761","type":"journal-article","created":{"date-parts":[[2022,1,11]],"date-time":"2022-01-11T14:05:07Z","timestamp":1641909907000},"page":"761","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":90,"title":["Risk Factors for Pressure Injuries in Adult Patients: A Narrative Synthesis"],"prefix":"10.3390","volume":"19","author":[{"given":"Man-Long","family":"Chung","sequence":"first","affiliation":[{"name":"Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, 53127 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Widdel","sequence":"additional","affiliation":[{"name":"Institute of Product Development and Engineering De sign, Technische Hochschule K\u00f6ln, 50679 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian","family":"Kirchhoff","sequence":"additional","affiliation":[{"name":"Institute of Product Development and Engineering De sign, Technische Hochschule K\u00f6ln, 50679 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Sellin","sequence":"additional","affiliation":[{"name":"Department of Digitalization and General Practice, University Hospital RWTH Aachen, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0347-9913","authenticated-orcid":false,"given":"Mohieddine","family":"Jelali","sequence":"additional","affiliation":[{"name":"Institute of Product Development and Engineering De sign, Technische Hochschule K\u00f6ln, 50679 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4212-9692","authenticated-orcid":false,"given":"Franziska","family":"Geiser","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, 53127 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"M\u00fccke","sequence":"additional","affiliation":[{"name":"Department of Digitalization and General Practice, University Hospital RWTH Aachen, 52074 Aachen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rupert","family":"Conrad","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Medicine and Psychotherapy, University Hospital Bonn, 53127 Bonn, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,1,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"103546","DOI":"10.1016\/j.ijnurstu.2020.103546","article-title":"Global prevalence and incidence of pressure injuries in hospitalised adult patients: A systematic review and meta-analysis","volume":"105","author":"Li","year":"2020","journal-title":"Int. J. Nurs. Stud."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1736","DOI":"10.1016\/S0140-6736(18)32203-7","article-title":"Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980\u20132017: A systematic analysis for the Global Burden of Disease Study 2017","volume":"392","author":"Roth","year":"2018","journal-title":"Lancet"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1016\/S0140-6736(14)61682-2","article-title":"Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990\u20132013: A systematic analysis for the Global Burden of Disease Study 2013","volume":"385","author":"Aboyans","year":"2015","journal-title":"Lancet Lond. Engl."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1016\/j.ijnurstu.2012.11.019","article-title":"Patient risk factors for pressure ulcer development: Systematic review","volume":"50","author":"Coleman","year":"2013","journal-title":"Int. J. Nurs. Stud."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.ijnurstu.2017.03.012","article-title":"Risk factors for pressure injuries among critical care patients: A systematic review","volume":"71","author":"Alderden","year":"2017","journal-title":"Int. J. Nurs. Stud."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2222","DOI":"10.1111\/jan.12405","article-title":"A new pressure ulcer conceptual framework","volume":"70","author":"Coleman","year":"2014","journal-title":"J. Adv. Nurs."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1016\/j.jclinepi.2021.03.001","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"134","author":"Page","year":"2021","journal-title":"J. Clin. Epidemiol."},{"key":"ref_8","unstructured":"Higgins, J.P.T., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M.J., and Welch, V.A. (2022, January 01). Cochrane Handbook for Systematic Reviews of Interventions Version 6.2 (Updated February 2021). Available online: www.training.cochrane.org\/handbook."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e031031","DOI":"10.1136\/bmjopen-2019-031031","article-title":"Design choices for observational studies of the effect of exposure on disease incidence","volume":"9","author":"Gail","year":"2019","journal-title":"BMJ Open"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"280","DOI":"10.7326\/0003-4819-158-4-201302190-00009","article-title":"Assessing bias in studies of prognostic factors","volume":"158","author":"Hayden","year":"2013","journal-title":"Ann. Intern. Med."},{"key":"ref_11","first-page":"CD012841","article-title":"Protease activity as a prognostic factor for wound healing in venous leg ulcers","volume":"9","author":"Westby","year":"2018","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1929","DOI":"10.1097\/BRS.0b013e3181b1c99f","article-title":"2009 Updated Method Guidelines for Systematic Reviews in the Cochrane Back Review Group","volume":"34","author":"Furlan","year":"2009","journal-title":"Spine"},{"key":"ref_13","unstructured":"Haesler, E. (2019). Prevention and Treatment of Pressure Ulcers\/Injuries: Quick Reference Guide, EPUAP\/NPIAP\/PPPIA."},{"key":"ref_14","unstructured":"Lovaasen, K.R., and Schwerdtfeger, J. (2013). ICD-9-CM Coding: Theory and Practice with ICD-10, Elsevier Health Sciences."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1002\/sim.4780030207","article-title":"Regression modelling strategies for improved prognostic prediction","volume":"3","author":"Harrell","year":"1984","journal-title":"Stat. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"361","DOI":"10.1002\/(SICI)1097-0258(19960229)15:4<361::AID-SIM168>3.0.CO;2-4","article-title":"Multivariable Prognostic Models: Issues in Developing Models, Evaluating Assumptions and Adequacy, and Measuring and Reducing Errors","volume":"15","author":"Harrell","year":"1996","journal-title":"Stat. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1373","DOI":"10.1016\/S0895-4356(96)00236-3","article-title":"A simulation study of the number of events per variable in logistic regression analysis","volume":"49","author":"Peduzzi","year":"1996","journal-title":"J. Clin. Epidemiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"808","DOI":"10.1002\/nop2.685","article-title":"Frequency and risk factors of pressure injuries in clinical settings of affiliated to Tabriz University of Medical Sciences","volume":"8","author":"Aghazadeh","year":"2021","journal-title":"Nurs. Open"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1001\/jama.1995.03520350047027","article-title":"Pressure Ulcer Risk Factors Among Hospitalized Patients With Activity Limitation","volume":"273","author":"Allman","year":"1995","journal-title":"JAMA"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1111\/iwj.13032","article-title":"Independent risk factors for pressure ulcer development in a high-risk nursing home population receiving evidence-based pressure ulcer prevention: Results from a study in 26 nursing homes in Belgium","volume":"16","author":"Anrys","year":"2019","journal-title":"Int. Wound J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"103760","DOI":"10.1016\/j.ijnurstu.2020.103760","article-title":"Prevalence, incidence and associated factors of pressure injuries in hospices: A multicentre prospective longitudinal study","volume":"111","author":"Artico","year":"2020","journal-title":"Int. J. Nurs. Stud."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1111\/j.1532-5415.2004.52358.x","article-title":"Black\/White Differences in Pressure Ulcer Incidence in Nursing Home Residents","volume":"52","author":"Baumgarten","year":"2004","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1111\/j.1532-5415.1996.tb05633.x","article-title":"Multi-site Study of Incidence of Pressure Ulcers and the Relationship Between Risk Level, Demographic Characteristics, Diagnoses, and Prescription of Preventive Interventions","volume":"44","author":"Bergstrom","year":"1996","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"747","DOI":"10.1111\/j.1532-5415.1992.tb01845.x","article-title":"A prospective study of pressure sore risk among institutionalized elderly","volume":"40","author":"Bergstrom","year":"1992","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/S1036-7314(01)80019-9","article-title":"Pressure sores in intensive care: Defining their incidence and associated factors and assessing the utility of two pressure sore risk assessment tools","volume":"14","author":"Boyle","year":"2001","journal-title":"Aust. Crit. Care"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1111\/j.1532-5415.1994.tb07486.x","article-title":"A Longitudinal Study of Risk Factors Associated with the Formation of Pressure Ulcers in Nursing Homes","volume":"42","author":"Brandeis","year":"1994","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"383","DOI":"10.12968\/jowc.2005.14.8.26820","article-title":"Prevalence, incidence and predictors of pressure ulcers in a tertiary hospital in Singapore","volume":"14","author":"Chan","year":"2005","journal-title":"J. Wound Care"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1097\/01.CCM.0000257072.10313.56","article-title":"Guideline implementation results in a decrease of pressure ulcer incidence in critically ill patients*","volume":"35","author":"Pickkers","year":"2007","journal-title":"Crit. Care Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1111\/j.1471-6712.1987.tb00603.x","article-title":"Prediction of Pressure Sore Development","volume":"1","author":"Ek","year":"1987","journal-title":"Scand. J. Caring Sci."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2984","DOI":"10.1111\/jocn.14491","article-title":"The use of a logistic regression model to develop a risk assessment of intraoperatively acquired pressure ulcer","volume":"27","author":"Gao","year":"2018","journal-title":"J. Clin. Nurs."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1028","DOI":"10.1111\/jocn.14091","article-title":"Incidence and risk factors associated with the development of pressure ulcers in an intensive care unit","volume":"27","year":"2018","journal-title":"J. Clin. Nurs."},{"key":"ref_32","first-page":"23","article-title":"Risk-Assessment Scores, Prevention Strategies, and the Incidence of Pressure Ulcers among the Elderly in Four Canadian Health-Care Facilities","volume":"30","author":"Goodridge","year":"1998","journal-title":"Can. J. Nurs. Res. Arch."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/S0020-7489(00)00010-9","article-title":"Validity and reliability of the Braden scale and the influence of other risk factors: A multi-centre prospective study","volume":"37","author":"Halfens","year":"2000","journal-title":"Int. J. Nurs. Stud."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1111\/jocn.13154","article-title":"Factors related to falls, weight-loss and pressure ulcers\u2014More insight in risk assessment among nursing home residents","volume":"25","author":"Lannering","year":"2016","journal-title":"J. Clin. Nurs."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"4119","DOI":"10.1111\/jocn.14967","article-title":"Pressure injury prevalence and predictors among older adults in the first 36 hours of hospitalisation","volume":"28","author":"Latimer","year":"2019","journal-title":"J. Clin. Nurs."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1007\/s11657-017-0365-9","article-title":"Pressure ulcers are associated with 6-month mortality in elderly patients with hip fracture managed in orthogeriatric care pathway","volume":"12","author":"Magny","year":"2017","journal-title":"Arch. Osteoporos."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2099","DOI":"10.1111\/jan.12077","article-title":"Comparison of alternating pressure mattresses and overlays for prevention of pressure ulcers in ventilated intensive care patients: A quasi-experimental study","volume":"69","author":"Manzano","year":"2013","journal-title":"J. Adv. Nurs."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1097\/00129334-200609000-00017","article-title":"A Prospective Cohort Study of Lower-Extremity Pressure Ulcer Risk Among Bedfast Older Adults","volume":"19","author":"Okuwa","year":"2006","journal-title":"Adv. Skin Wound Care"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"e12821","DOI":"10.1111\/ijn.12821","article-title":"Incidence and risk factors associated with pressure injury in patients with traumatic brain injury","volume":"26","author":"Osis","year":"2020","journal-title":"Int. J. Nurs. Pract."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1016\/S0895-4356(01)00514-5","article-title":"Screening for pressure ulcer risk in an acute care hospital: Development of a brief bedside scale","volume":"55","author":"Perneger","year":"2002","journal-title":"J. Clin. Epidemiol."},{"key":"ref_41","first-page":"152","article-title":"Risk factors for bedsore development among hospitalised patients","volume":"2018","author":"Popow","year":"2019","journal-title":"Piel\u0119gniarstwo Chir. Angiol. Vasc. Nurs."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1053\/apnr.2002.34145","article-title":"Risk indicators for pressure ulcers during surgery","volume":"15","author":"Schoonhoven","year":"2002","journal-title":"Appl. Nurs. Res."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1111\/iwj.13352","article-title":"Risk for undernutrition and development of pressure injury in hospitalised patients in Brazil: Multicentre prospective cohort study","volume":"17","author":"Serpa","year":"2020","journal-title":"Int. Wound J."},{"key":"ref_44","first-page":"416896","article-title":"Incidence and predicted risk factors of pressure ulcers in surgical patients: Experience at a medical center in Taipei, Taiwan","volume":"2014","author":"Shaw","year":"2014","journal-title":"BioMed Res. Int."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1111\/j.1478-5153.2007.00250.x","article-title":"Development of a new risk assessment scale for predicting pressure ulcers in an intensive care unit","volume":"13","author":"Suriadi","year":"2008","journal-title":"Nurs. Crit. Care"},{"key":"ref_46","unstructured":"Tourtual, D.M., Riesenberg, L.A., Korutz, C.J., Semo, A.H., Asef, A., Talati, K., and Gill, R.D. (1997). Predictors of hospital acquired heel pressure ulcers. Ostomy. Wound Manag., 43."},{"key":"ref_47","first-page":"11","article-title":"Pressure ulcers and malnutrition: Results from a snapshot sampling in a university hospital","volume":"24","author":"Tsaousi","year":"2015","journal-title":"Med. Princ. Pract. Int. J. Kuwait Univ. Health Sci. Cent."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"379","DOI":"10.5455\/medarh.2016.70.379-383","article-title":"Pressure Ulcers: Developing Clinical Indicators in Evidence-based Practice. A Prospective Study","volume":"70","author":"Tsaras","year":"2016","journal-title":"Med. Arch."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1698","DOI":"10.1111\/jgs.12455","article-title":"Mini nutritional assessment as a useful method of predicting the development of pressure ulcers in elderly inpatients","volume":"61","author":"Yatabe","year":"2013","journal-title":"J. Am. Geriatr. Soc."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1111\/iwj.13007","article-title":"A prediction tool for hospital-acquired pressure ulcers among surgical patients: Surgical pressure ulcer risk score","volume":"16","author":"Aloweni","year":"2019","journal-title":"Int. Wound J."},{"key":"ref_51","first-page":"339","article-title":"Pressure ulcers in community-based older adults receiving home health care. Prevalence, incidence, and associated risk factors","volume":"12","author":"Bergquist","year":"1999","journal-title":"Adv. Wound Care J. Prev. Heal."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"1589","DOI":"10.1111\/jdv.14911","article-title":"Risk of developing pressure sore in amyotrophic lateral sclerosis patients\u2014A nationwide cohort study","volume":"32","author":"Chen","year":"2018","journal-title":"J. Eur. Acad. Dermatol. Venereol. JEADV"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"417","DOI":"10.12968\/jowc.2008.17.10.31304","article-title":"Pressure ulcer predictors in ICU patients: Nursing skin assessment versus objective parameters","volume":"17","author":"Compton","year":"2008","journal-title":"J. Wound Care"},{"key":"ref_54","first-page":"364","article-title":"Predictors of pressure ulcers in adult critical care patients","volume":"20","author":"Cox","year":"2011","journal-title":"Am. J. Crit. Care Off. Publ. Am. Assoc. Crit.-Care Nurses"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"204","DOI":"10.4037\/ajcc2020243","article-title":"Identifying Risk Factors for Pressure Injury in Adult Critical Care Patients","volume":"29","author":"Cox","year":"2020","journal-title":"Am. J. Crit. Care"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"30","DOI":"10.4037\/ccn2018993","article-title":"Pressure Injury Development in Patients Treated by Critical Care Air Transport Teams: A Case-Control Study","volume":"38","author":"Dukes","year":"2018","journal-title":"Crit. Care Nurse"},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"342","DOI":"10.5435\/JAAOS-D-19-00104","article-title":"Postoperative Pressure Ulcers After Geriatric Hip Fracture Surgery Are Predicted by Defined Preoperative Comorbidities and Postoperative Complications","volume":"28","author":"Galivanche","year":"2020","journal-title":"J. Am. Acad. Orthop. Surg."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"3780","DOI":"10.1111\/jocn.14600","article-title":"Predictors of hospital-acquired pressure ulcers among older adult inpatients","volume":"27","author":"Han","year":"2018","journal-title":"J. Clin. Nurs."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Kim, J., Lee, J.-Y., and Lee, E. (2019). Risk factors for newly acquired pressure ulcer and the impact of nurse staffing on pressure ulcer incidence. J. Nurs. Manag., 1\u20139.","DOI":"10.1111\/jonm.12928"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"43","DOI":"10.5937\/sjecr13-1656","article-title":"Predictors of pressure ulcers in patients with spinal cord injuries","volume":"13","year":"2012","journal-title":"Serb. J. Exp. Clin. Res."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1177\/1460458219832053","article-title":"Patient-specific factors associated with pressure injuries revealed by electronic health record analyses","volume":"26","author":"Miller","year":"2020","journal-title":"Health Inform. J."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1097\/CCM.0b013e318298a849","article-title":"Intraoperative risk factors associated with postoperative pressure ulcers in critically ill patients: A retrospective observational study","volume":"42","author":"Shanks","year":"2014","journal-title":"Crit. Care Med."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1093\/ageing\/28.1.45","article-title":"Nursing home characteristics and the development of pressure sores and disruptive behaviour","volume":"28","author":"Ooi","year":"1999","journal-title":"Age Ageing"},{"key":"ref_64","first-page":"1113","article-title":"Factors Affecting the Time to Occurrence of Hospital-Acquired Pressure Ulcers Using EHR Data","volume":"245","author":"Park","year":"2017","journal-title":"Stud. Health Technol. Inform."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1007\/s00068-007-6212-8","article-title":"Pressure Ulcers and Prolonged Hospital Stay in Hip Fracture Patients Affected by Time-to-Surgery","volume":"33","author":"Rademakers","year":"2007","journal-title":"Eur. J. Trauma Emerg. Surg. Off. Publ. Eur. Trauma Soc."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1159\/000070407","article-title":"Low serum albumin levels, confusion, and fecal incontinence: Are these risk factors for pressure ulcers in mobility-impaired hospitalized adults?","volume":"49","author":"Reed","year":"2003","journal-title":"Gerontology"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1097\/NNR.0000000000000258","article-title":"Hospital-Acquired Pressure Injury: Risk-Adjusted Comparisons in an Integrated Healthcare Delivery System","volume":"67","author":"Rondinelli","year":"2018","journal-title":"Nurs. Res."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"102924","DOI":"10.1016\/j.iccn.2020.102924","article-title":"Predictors of pressure injury development in critically ill adults: A retrospective cohort study","volume":"62","author":"Sala","year":"2020","journal-title":"Intensive Crit. Care Nurs."},{"key":"ref_69","first-page":"45","article-title":"Predicting Pressure Ulcers during Initial Hospitalization for Acute Spinal Cord Injury","volume":"11","author":"Salzberg","year":"1999","journal-title":"Wounds"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1016\/j.jtv.2018.01.002","article-title":"Pressure ulcer incidence and Braden subscales: Retrospective cohort analysis in general wards of a Portuguese hospital","volume":"27","author":"Sardo","year":"2018","journal-title":"J. Tissue Viability"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"37","DOI":"10.2147\/CIA.S122464","article-title":"Pressure ulcers in palliative ward patients: Hyponatremia and low blood pressure as indicators of risk","volume":"12","author":"Sternal","year":"2016","journal-title":"Clin. Interv. Aging"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1111\/jonm.12671","article-title":"Pressure injuries in critical patients: Incidence, patient-associated factors, and nursing workload","volume":"27","author":"Nogueira","year":"2019","journal-title":"J. Nurs. Manag."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"282","DOI":"10.1097\/WON.0b013e3182435715","article-title":"All at-risk patients are not created equal: Analysis of Braden pressure ulcer risk scores to identify specific risks","volume":"39","author":"Tescher","year":"2012","journal-title":"J. Wound Ostomy Cont. Nurs. Off. Publ. Wound Ostomy Cont. Nurses Soc."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1206","DOI":"10.1111\/iwj.12445","article-title":"Risk factors associated with intraoperatively acquired pressure ulcers in the park-bench position: A retrospective study","volume":"13","author":"Yoshimura","year":"2016","journal-title":"Int. Wound J."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.jtv.2019.02.001","article-title":"Incidence of pressure ulcers in intensive care units and direct costs of treatment: Evidence from Iran","volume":"28","author":"Zarei","year":"2019","journal-title":"J. Tissue Viability"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0899-9007(99)00227-0","article-title":"A multi-center trial of the effects of oral nutritional supplementation in critically ill older inpatients","volume":"16","author":"Barateau","year":"2000","journal-title":"Nutrition"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1111\/j.1365-2702.2004.01058.x","article-title":"Pressure ulcers: Validation of two risk assessment scales","volume":"14","author":"Defloor","year":"2005","journal-title":"J. Clin. Nurs."},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Donnelly, J., Winder, J., Kernohan, W.G., and Stevenson, M. (2011). An RCT to determine the effect of a heel elevation device in pressure ulcer prevention post-hip fracture. J. Wound Care, 20.","DOI":"10.12968\/jowc.2011.20.7.309"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/0261-5614(91)90002-T","article-title":"The development and healing of pressure sores related to the nutritional state","volume":"10","author":"Ek","year":"1991","journal-title":"Clin. Nutr."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1111\/iwj.12875","article-title":"Effectiveness of using a new polyurethane foam multi-layer dressing in the sacral area to prevent the onset of pressure ulcer in the elderly with hip fractures: A pragmatic randomised controlled trial","volume":"15","author":"Forni","year":"2018","journal-title":"Int. Wound J."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"1679","DOI":"10.1007\/s00134-014-3424-3","article-title":"Comparison of two repositioning schedules for the prevention of pressure ulcers in patients on mechanical ventilation with alternating pressure air mattresses","volume":"40","author":"Manzano","year":"2014","journal-title":"Intensive Care Med."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"1413","DOI":"10.1136\/bmj.38849.478299.7C","article-title":"Randomised, controlled trial of alternating pressure mattresses compared with alternating pressure overlays for the prevention of pressure ulcers: PRESSURE (pressure relieving support surfaces) trial","volume":"332","author":"Nixon","year":"2006","journal-title":"BMJ"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1016\/S0001-2092(06)62325-9","article-title":"Etiology and Incidence of Pressure Ulcers in Surgical Patients","volume":"70","author":"Schultz","year":"1999","journal-title":"AORN J."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"3050","DOI":"10.1111\/j.1365-2702.2009.02860.x","article-title":"The identification of older nursing home residents vulnerable for deterioration of grade 1 pressure ulcers","volume":"18","author":"Vanderwee","year":"2009","journal-title":"J. Clin. Nurs."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1002\/sim.2331","article-title":"Dichotomizing continuous predictors in multiple regression: A bad idea","volume":"25","author":"Royston","year":"2006","journal-title":"Stat. Med."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1097\/00006199-198707000-00002","article-title":"The Braden Scale for Predicting Pressure Sore Risk","volume":"36","author":"Bergstrom","year":"1987","journal-title":"Nurs. Res."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"56","DOI":"10.7812\/TPP\/09-117","article-title":"Pressure Ulcers: What Clinicians Need to Know","volume":"14","author":"Wake","year":"2010","journal-title":"Perm. J."},{"key":"ref_88","first-page":"26","article-title":"Pressure ulcer education 3: Skin assessment and care","volume":"115","author":"Fletcher","year":"2019","journal-title":"Nurs. Times Online"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/01.ASW.0000653164.21235.27","article-title":"The Effect of Pressure Injury Training for Nurses: A Systematic Review and Meta-analysis","volume":"33","author":"Kim","year":"2020","journal-title":"Adv. Skin Wound Care"},{"key":"ref_90","unstructured":"Takahashi, M., Black, J., Dealey, C., and Gefen, A. (2010). Pressure in context. International review. Pressure Ulcer Prevention: Pressure, Shear, Friction and Microclimate in Context. A Consensus Document, Wounds International."},{"key":"ref_91","unstructured":"De Benoist, B., World Health Organization, and Centers for Disease Control and Prevention (U.S.) (2008). Worldwide Prevalence of Anaemia 1993\u20132005 of: WHO Global Database of Anaemia, World Health Organization."},{"key":"ref_92","first-page":"64","article-title":"Treatment of chronic skin ulcers in individuals with anemia of chronic disease using recombinant human erythropoietin (EPO): A review of four cases","volume":"50","author":"Keast","year":"2004","journal-title":"Ostomy. Wound Manag."},{"key":"ref_93","first-page":"223","article-title":"Die aktualisierte Version der ASA-Klassifikation","volume":"62","author":"Defosse","year":"2021","journal-title":"An\u00e4sth Intensivmed"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"1771","DOI":"10.1161\/CIRCRESAHA.115.306884","article-title":"Vascular Complications of Diabetes","volume":"118","author":"Beckman","year":"2016","journal-title":"Circ. Res."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"2076","DOI":"10.1038\/sj.bjc.6602619","article-title":"Type-II diabetes and pancreatic cancer: A meta-analysis of 36 studies","volume":"92","author":"Huxley","year":"2005","journal-title":"Br. J. Cancer"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"2313","DOI":"10.2337\/dc20-0204","article-title":"Association of Type 2 Diabetes With Cancer: A Meta-analysis With Bias Analysis for Unmeasured Confounding in 151 Cohorts Comprising 32 Million People","volume":"43","author":"Ling","year":"2020","journal-title":"Diabetes Care"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.jpsychores.2012.11.013","article-title":"Association of diabetes with anxiety: A systematic review and meta-analysis","volume":"74","author":"Smith","year":"2013","journal-title":"J. Psychosom. Res."},{"key":"ref_98","doi-asserted-by":"crossref","unstructured":"Aromataris, E., and Munn, Z. (2020). Chapter 7: Systematic Reviews of Etiology and Risk. JBI Manual for Evidence Synthesis, JBI. Available online: https:\/\/synthesismanual.jbi.global.","DOI":"10.46658\/JBIRM-17-01"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/2\/761\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T14:01:57Z","timestamp":1760364117000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/2\/761"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,1,11]]},"references-count":98,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,1]]}},"alternative-id":["ijerph19020761"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19020761","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,1,11]]}}}