• Am. J. Crit. Care · Jul 2020

    Multicenter Study

    Predictive Modeling of Pressure Injury Risk in Patients Admitted to an Intensive Care Unit.

    • Mireia Ladios-Martin, José Fernández-de-Maya, Francisco-Javier Ballesta-López, Adrián Belso-Garzas, Manuel Mas-Asencio, and María José Cabañero-Martínez.
    • About the Authors: Mireia Ladios-Martin is head of quality, Ribera Salud, Valencia, Spain.
    • Am. J. Crit. Care. 2020 Jul 1; 29 (4): e70-e80.

    BackgroundPressure injuries are an important problem in hospital care. Detecting the population at risk for pressure injuries is the first step in any preventive strategy. Available tools such as the Norton and Braden scales do not take into account all of the relevant risk factors. Data mining and machine learning techniques have the potential to overcome this limitation.ObjectivesTo build a model to detect pressure injury risk in intensive care unit patients and to put the model into production in a real environment.MethodsThe sample comprised adult patients admitted to an intensive care unit (N = 6694) at University Hospital of Torrevieja and University Hospital of Vinalopó. A retrospective design was used to train (n = 2508) and test (n = 1769) the model and then a prospective design was used to test the model in a real environment (n = 2417). Data mining was used to extract variables from electronic medical records and a predictive model was built with machine learning techniques. The sensitivity, specificity, area under the curve, and accuracy of the model were evaluated.ResultsThe final model used logistic regression and incorporated 23 variables. The model had sensitivity of 0.90, specificity of 0.74, and area under the curve of 0.89 during the initial test, and thus it outperformed the Norton scale. The model performed well 1 year later in a real environment.ConclusionsThe model effectively predicts risk of pressure injury. This allows nurses to focus on patients at high risk for pressure injury without increasing workload.© 2020 American Association of Critical-Care Nurses.

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