Development of a Nomogram for Predicting the Risk of Hospital-Acquired Pressure Injuries in Patients in the Cardiovascular Intensive Care Unit

Background: Hospital acquired pressure injuries (HAPIs) increase the medical burden of patients in the cardiovascular intensive care unit (CCU). Thus, identification of CCU patients with a risk for HAPIs is important. Objective: To establish a nomogram model for predicting the occurrence of HAPIs in patients in the CCU. Methods: This was a retrospective cohort study of patients in the CCU at our hospital who developed HAPIs between January 2023 and June 2023. Patient data were extracted from the hospital's information management system. Risk factors for HAPIs were identified using univariate and multivariate logistic regression analyses and integrated into a nomogram. The effectiveness of the nomogram was evaluated and verified using receiver operating characteristic curve and decision curve analysis (DCA). Results: A total of 161 patients were included in this study. Univariate logistic regression analysis showed that vasopressor use and NT proBNP, lactic acid, procalcitonin, D-dimer, and albumin levels were independent risk factors for HAPIs. Multivariate logistic regression analysis showed that vasopressor use (OR=3.049, 95%CI=1.203-7.729, P=0.019) and lactic acid (OR=12.053, 95%Cl=4.125-35.210, P=0.000), procalcitonin (OR=1.304, 95%Cl=1.008-1.687, P=0.043) and albumin (OR=0.823, 95%Cl=0.729-0.928, P=0.002) levels were independent risk factors for HAPIs. The nomogram was well-calibrated and showed good discriminative ability (AUC=0.868). The DCA showed a better net benefit, and the results were verified in the validation cohort. Conclusion: The nomogram model developed in this study showed good predictability and can identify patients at risk of developing HAPIs and aid the formulation of targeted interventions. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study did not receive any funding ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This study was approved by the Ethics Committee of Renmin Hospital. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors