Aim: To describe the cumulative incidence and characteristics of hospital-acquired pressure injury in acute palliative patients.

Design: Secondary data analysis of hospital-acquired pressure injuries during 2019-2022.

Methods: The setting was a palliative care unit at a tertiary hospital in Queensland, Australia, including adult (≥ 18 years) acute-phase palliative inpatients. Retrospective data from four databases were used to identify and analyse hospital-acquired pressure injury cases from 2019 to 2022. Clinical characteristics of patients with and without hospital-acquired pressure injury were compared.

Results: The incidence of hospital-acquired pressure injury in acute palliative care patients was 3.9% over the 4 years. These patients were predominantly male, with an average age of 74 years, with 66 of 78 cases developing in the deteriorating palliative care phase. Using the Waterlow Score, 51.3% of patients were assessed as at very high risk of pressure injury. Ninety-five hospital-acquired pressure injuries were reported in 78 patients; 16.8% were medical device-related, 40% were Stage 1 injuries, and the most common injury sites were the sacrum, heels and genitals. Patients with hospital-acquired pressure injury had significantly higher (worse) scores on both the palliative care Resource Utilisation Group-Activities of Daily Living and Problem Severity Scores. Regression analysis identified a high Problem Severity Score on admission as a significant predictor for hospital-acquired pressure injury development.

Conclusion: The incidence of hospital-acquired pressure injury in acute palliative patients is lower than in previous studies. However, many injuries occurred in those in the deteriorating phase, with higher scores for severity of symptoms. These findings suggest that acute palliative patients do require nursing care for pressure injury prevention, as well as for symptom management and activities-of-daily-living. Overall, this research contributes to a deeper understanding of pressure injury incidence and characteristics for acute palliative care patients. Future research should focus on population-specific pressure injury risk assessment to explore risk factors in greater detail.

Implications for the profession and/or patient care: Current pressure injury risk assessment tools, like the Waterlow Score, may not provide the comprehensive evaluation needed for the acute palliative care cohort. To better address the unique needs of this cohort, it may be necessary to refine existing tools or develop new instruments that integrate palliative-specific assessments, such as the Resource Utilisation Group-Activities-of-Daily-Living (RUG-ADL) and Problem (symptom) Severity Score (PSS). These adaptations could help improve pressure injury prevention care planning and enhance outcomes for patients in this setting.

Impact: This study separated acute palliative care patients from those at end-of-life and found a 3.9% cumulative incidence of pressure injuries. There were no significant differences in age, gender, or cancer diagnosis between patients with and without injuries. Patients without injuries were more likely to be in the deteriorating phase, while those with injuries had higher (worse) RUG-ADL scores. Regression analysis showed that each one-point increase in the PSS (symptom severity) made patients 1.2 times more likely to develop a pressure injury. The findings suggest that combining a validated risk assessment tool with the RUG-ADL and PSS tools could provide a more accurate risk assessment for hospitalised acute palliative care patients.

Reporting method: STROBE reporting guideline.

Patient or public contribution: No patient or public contribution.

Keywords: acute patients; palliative care; pressure injury.

© 2025 The Author(s). Journal of Clinical Nursing published by John Wiley & Sons Ltd.

目的： 描述急性姑息治疗患者中医院获得性压力性损伤的累积发生率和特征。

设计： 对2019年至2022年期间医院获得性压力性损伤数据进行二次分析。

方法： 研究设置为澳大利亚昆士兰州三级医院的姑息治疗病房，包括急性期（≥18岁）姑息治疗住院患者。使用四份数据库中的回顾性数据来识别和分析2019年至2022年期间的医院获得性压力性损伤案例，并比较有无医院获得性压力性损伤患者的临床特征。

结果： 在急性姑息治疗患者中，4年内医院获得性压力性损伤的发生率为3.9%。这些患者主要是男性，平均年龄为74岁，在病情恶化的姑息期有78例中的66例发生。使用Waterlow评分系统评估，51.3%的患者被评定为极高风险。在78名患者中报告了95个医院获得性压力性损伤案例；其中16.8%与医疗设备相关，40%为第一期伤口，最常见的受伤部位是骶骨、足跟和生殖器区域。患有医院获得性压力性损伤的患者在姑息护理资源利用组日常生活活动量表（RUG-ADL）和问题严重程度评分上的得分显著较高（更差）。回归分析发现入院时的问题严重程度评分为医院获得性压力性损伤发生的显著预测因素。

结论： 急性姑息治疗患者中医院获得性压力性损伤的发生率低于先前的研究。然而，许多损伤发生在病情恶化的阶段，并且这些患者的症状严重度评分较高。这表明急性姑息治疗的患者确实需要护理以预防压力性损伤以及管理症状和日常生活活动。总的来说，这项研究有助于更深入地理解急性姑息治疗患者中压力性损伤的发生率及特征。未来的研究应侧重于特定人群的压力性损伤风险评估，以便详细探讨风险因素。

对专业实践或患者护理的影响： 目前的压力性损伤风险评估工具（如Waterlow评分）可能无法为急性姑息治疗组提供全面的评价。为了更好地满足这一群体的独特需求，可能需要完善现有的工具或者开发新的结合了特定姑息治疗评估方法（例如RUG-ADL和问题严重度评分PSS）的新工具。这些改进可以帮助改善压力性损伤预防护理计划并提高这类患者在该环境下的结果。

影响： 本研究将急性姑息治疗患者与终末期患者分开，发现3.9%的累积发生率的压力性损伤。有无伤口患者之间年龄、性别或癌症诊断没有显著差异。未受伤的患者更有可能处于病情恶化的阶段，而受伤者RUG-ADL评分更高（更差）。回归分析显示PSS每增加一个点（症状严重度），患者发展为压力性损伤的可能性会增加1.2倍。结果表明结合经验证的风险评估工具与RUG-ADL和PSS工具可以提供更准确的住院急性姑息治疗患者的医院获得性压力性损伤风险评估。

报告方法： STROBE报道指南。

患者或公众贡献： 无患者或公众参与。