Risk factors of pressure injury in elderly inpatients: a systematic review and meta-analysis.

OBJECTIVE

The aim of this systematic review is to systematically identify and synthesize the risk factors contributing to pressure injury in elderly inpatients.

Methods

PubMed, Embase, Web of Science, Cochrane Library, and CINAHL were systematically searched from database inception to March 1, 2025. Two researchers independently screened the retrieved studies and extracted the data. The risk of bias was assessed using the AHRQ criteria or the Newcastle–Ottawa Scale (NOS). Meta-analysis was performed using R version 4.5.0.

Results

A total of 3,629 studies were retrieved, and 23 studies met the inclusion criteria. Altogether, 70,340 participants were included in the analysis, of whom 5,792 developed PI during hospitalization, corresponding to an overall prevalence of 8.2%. Meta-analysis showed that age (OR = 1.06, 95%CI: 1.03 to 1.09), immobility (OR = 4.54, 95%CI: 3.09 to 6.67), incontinence (OR = 4.54, 95%CI: 2.33 to 42.75), nutritional risk (OR = 3.00, 95%CI: 1.78 to 5.05), diabetes (OR = 1.60, 95%CI: 1.21 to 2.11), durations of prior ICU stay (OR = 1.93, 95%CI: 1.46 to 2.55), time from admission to surgery (OR = 2.07, 95%CI: 1.60 to 2.67) and length of stay (OR = 1.05, 95%CI: 1.01 to 1.01) were associated with pressure injury in elderly inpatients.

Conclusions

Pressure injury remains a serious and preventable complication among elderly inpatients. This study provided a comprehensive evaluation of the risk factors of pressure injury development among elderly inpatients, identifying eight major contributors. These findings may promote valuable evidence to inform clinical assessment, risk stratification, and the development of targeted prevention strategies.