PhD in Nursing Science Program

Richard A. Benoit

Risk Factors for Pressure Ulcer Development in Critically Ill Patients


Dissertation under the direction of Professor Lorraine Mion


Of the patient populations in acute care facilities, the critically ill are most vulnerable to the development of pressure ulcers. The most commonly used pressure ulcer risk assessment tool in the United States, the Braden Scale, demonstrates low levels of specificity when used to predict pressure ulcer incidence in the critically ill, suggesting that additional risk factors may help to focus prevention efforts. As the framework for the investigation of pressure ulcer risk factors in critically ill patients, additional risk factors identified in the literature that are specific to this patient population were evaluated simultaneously with the Braden Scale using a case-control study design. The Braden Scale scores and additional risk factors were compared in pressure ulcer positive and negative patients.

Hierarchical logistic regression determined that the Braden Scale was statistically significantly associated with pressure ulcer development when used alone, and the addition of other variables at both 24 and 48 hours did contribute statistically significantly to the overall model. Male gender and low hematocrit values were statistically significantly associated with pressure ulcer development when analyzed at univariate and multivariate levels, and increased age demonstrated a statistically significant association with pressure ulcer incidence with multivariate analysis. Restraint use was identified as a statistically significant protective factor with multivariate analysis.