The predictive role of albumin, neutrophil-to-lymphocyte ratio, and systemic immune inflammation index in pressure ulcer risk among palliative care patients- a retrospective analysis.

INTRODUCTION

Pressure ulcers (PUs) are a major concern in palliative care due to patients' immobility and multiple comorbidities. Early identification of at-risk individuals is essential for prevention. Hematological markers such as neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) may assist in risk prediction.

Objectives

This study aimed to evaluate the predictive value of inflammatory markers for PU development in palliative care patients retrospectively.

METHODS

Adult patients hospitalized in a palliative care unit for at least three months and free of PUs at admission were included. They were categorized into two groups: those who developed PUs during follow-up (wPU) and those who did not (woPU). Demographic, clinical, and laboratory variables were compared.

RESULTS

A total of 82 patients (mean age: 78.6 ± 11 years) were analyzed. No significant differences were found between groups in terms of age, sex, Charlson Comorbidity Index, or Braden score. The wPU group had significantly lower serum albumin (p = 0.004), and higher NLR (p = 0.04) and SII (p = 0.04) levels.

CONCLUSION

Hypoalbuminemia and elevated NLR independently predict PU development in palliative care, highlighting the importance of nutritional and inflammatory status. Albumin, NLR, and SII had only moderate accuracy but may provide supportive value when combined with clinical risk tools.