Risk Factors of Intraoperative Pressure Injury in Adult Patients Undergoing Neurologic Surgery

BACKGROUND: Intraoperative pressure injury (PI) development is an adverse event that impacts thousands of patients globally and is associated with extended hospital stays and increased risk of mortality. OBJECTIVE: To investigate the incidence of intraoperative PI in patients undergoing neurologic surgery and identify associated risk factors. METHODS: A total of 1,728 patients who underwent neurosurgery in Xiangya Hospital, Central South University between January 2021 and December 2022 were included in this retrospective study. The authors collected patients' demographic data and clinical characteristics and used univariate and multivariate regression to evaluate significant PI risk factors. RESULTS: Intraoperative PI was observed in 1.8% of all surgical cases (n = 31). Having a body mass index greater than 24 kg/m(2) (odds ratio, 3.87; 95% CI, 1.62-9.23; P = .002), being in a lateral position (odds ratio, 2.53; 95% CI, 1.04-6.17; P = .042) or a prone position (odds ratio, 10.43; 95% CI, 3.37-32.23; P < .001), and having a longer operation time (cutoff point at 7.92 hours for increased risk of PI; odds ratio, 1.36; 95% CI, 1.21-1.53; P < .001) were significant risk factors for intraoperative PI. CONCLUSION: This study identified three independent risk factors for intraoperative PI development: body position, surgery duration, and high body mass index. These findings can help OR nurses identify patients who are vulnerable to intraoperative PI and provide appropriate preventive measures. For these patients, perioperative protection and frequent microrepositioning during surgery would be indispensable.