# Factors Associated with Pressure Injury Occurrence in Older Trauma Patients

## TL;DR

This study finds that frailty, low BMI, low albumin, and longer hospital stays are linked to pressure injuries in older trauma patients.

## Contribution

The study specifically examines the role of frailty in pressure injury development among older Asian trauma patients.

## Key findings

- Higher frailty scores are independently associated with pressure injury occurrence.
- Lower BMI and hypoalbuminemia increase the risk of hospital-acquired pressure injuries.
- Prolonged hospital stay is a significant factor for pressure injury development.

## Abstract

Background/Objectives: Older individuals are more vulnerable to stress and trauma. Although pressure injuries (PIs) are recognized as a significant complication, the specific impact of frailty on PI development in older Asian trauma patients remains insufficiently explored. This study aims to investigate the factors associated with the occurrence of hospital-acquired pressure injuries (HAPU) in older patients aged ≥65 years, including frailty. Methods: This study is a retrospective secondary data analysis of 3418 older trauma patients admitted to a regional trauma center (including ICU and trauma ward) from 1 January 2020 to 31 December 2023. Patients with PIs present on admission (POA) were excluded to strictly analyze new PI occurrence. Frailty was assessed using the mFI-5. Results: The mean age of participants was 77.33 years. During hospitalization, 2.5% (n = 84) of patients developed new PIs. Multivariate logistic regression identified that higher frailty score (Odds Ratio [OR] = 1.59, 95% Confidence Interval [CI]: 1.26–2.02), lower BMI (OR = 0.93, 95% CI: 0.86–0.99), hypoalbuminemia (OR = 0.55, 95% CI: 0.36–0.84), and prolonged hospital stay (OR = 1.05, 95% CI: 1.04–1.06) were independently associated with PI occurrence. Chronological age was not a significant predictor in the multivariate model. Conclusions: Frailty, nutritional status (BMI, albumin), and prolonged hospital stay are significant factors associated with HAPU in older trauma patients.