# Risk factors of pressure injury in elderly inpatients: a systematic review and meta-analysis

## TL;DR

This study identifies key risk factors for pressure injuries in elderly hospitalized patients and highlights their preventability.

## Contribution

A comprehensive meta-analysis revealing eight major risk factors for pressure injury in elderly inpatients.

## Key findings

- Immobility and incontinence show the highest odds ratios for pressure injury development.
- Nutritional risk and diabetes are significant contributors to pressure injury prevalence.
- Longer hospital stays and ICU durations increase the risk of pressure injuries.

## Abstract

The aim of this systematic review is to systematically identify and synthesize the risk factors contributing to pressure injury in elderly inpatients. Methods: PubMed, Embase, Web of Science, Cochrane Library, and CINAHL were systematically searched from database inception to March 1, 2025. Two researchers independently screened the retrieved studies and extracted the data. The risk of bias was assessed using the AHRQ criteria or the Newcastle–Ottawa Scale (NOS). Meta-analysis was performed using R version 4.5.0. Results: A total of 3,629 studies were retrieved, and 23 studies met the inclusion criteria. Altogether, 70,340 participants were included in the analysis, of whom 5,792 developed PI during hospitalization, corresponding to an overall prevalence of 8.2%. Meta-analysis showed that age (OR = 1.06, 95%CI: 1.03 to 1.09), immobility (OR = 4.54, 95%CI: 3.09 to 6.67), incontinence (OR = 4.54, 95%CI: 2.33 to 42.75), nutritional risk (OR = 3.00, 95%CI: 1.78 to 5.05), diabetes (OR = 1.60, 95%CI: 1.21 to 2.11), durations of prior ICU stay (OR = 1.93, 95%CI: 1.46 to 2.55), time from admission to surgery (OR = 2.07, 95%CI: 1.60 to 2.67) and length of stay (OR = 1.05, 95%CI: 1.01 to 1.01) were associated with pressure injury in elderly inpatients. Conclusions: Pressure injury remains a serious and preventable complication among elderly inpatients. This study provided a comprehensive evaluation of the risk factors of pressure injury development among elderly inpatients, identifying eight major contributors. These findings may promote valuable evidence to inform clinical assessment, risk stratification, and the development of targeted prevention strategies.

The online version contains supplementary material available at 10.1186/s12877-025-06517-0.