Identification of Risk Factors for Intraoperative Acquired Pressure Injury in Patients Undergoing Neurosurgery: A Retrospective Single-Center Study

BACKGROUND: Risk factors for intraoperative acquired pressure injury (IAPI) in patients undergoing various surgical procedures have been described in previous studies. However, whether risk factors for IAPI in patients undergoing neurosurgery differ remains unknown. The aim of the present study was to explore independent risk factors for IAPI in patients undergoing neurosurgery. MATERIAL/METHODS: Data from 465 patients who underwent neurosurgery between October 2017and December 2018 and who were at high risk of IAPIs were retrospectively analyzed. Independent risk factors for IAPI were evaluated using univariate and multivariate logistic regression models. RESULTS: Sixty-nine IAPIs (14.8%) in 465 patients undergoing neurosurgery were assessed. Multivariate logistic regression analyses showed that being overweight (odds ratio [OR] 2.685; 95% confidence interval [CI] 1.206–5.975; P=0.016), prone position (OR 7.502, 95% CI 2.470–22.787. P<0.001), lateral position (OR 15.301, 95% CI 4.903–47.753, P<0.001), use of a head frame (OR 3.716, 95% CI 1.431–9.653, P=0.007), surgical times of 4 to 8 h (OR 7.276, 95% CI 2.249–23.542, P<0.001), and surgical times ≥8 h (OR 173.248, 95% CI 32.629–919.896, P<0.001) all were associated with an increased risk of IAPI in patients undergoing neurosurgery. The factors associated with reduced risk of IAPI were high serum albumin levels (OR 0.099, 95% CI 0.016–0.608, P=0.013) and use of memory sponge pads (OR 0.064, 95% CI 0.020–0.202, P<0.001). CONCLUSIONS: The present study indicates that being overweight, prone and lateral positioning, use of a head frame, and longer surgical times are associated with an increased risk of IAPI in patients undergoing neurosurgery. Prospective studies should be conducted to verify these findings and consideration should be given to use of these factors in clinical practice to identify high-risk patients.