Incidences of pressure injury in neurosurgery at Neurological Institute of Thailand

Abstract

Background: Background: Pressure injuries (PIs) are severe complications associated with pain, infection risks, and significant increases in medical costs. Neurosurgical patients face elevated risks due to prolonged operative durations, averaging 4–8 hours, and immobility under general anesthesia. These conditions impair blood circulation, leading to tissue hypoxia and subsequent cellular necrosis. Objective: This study aimed to investigate the incidence and analyze factors influencing the occurrence of PIs among patients undergoing neurosurgery in prone and lateral positions at the Neurological Institute of Thailand. Methods: A retrospective analytic study was conducted to determine the predictive power and associations of various factors. The sample consisted of 142 male and female neurosurgical patients aged 18 years and older. Data were analyzed using descriptive statistics, Chi-square test, Fisher’s exact test, and binary logistic regression. Results: The overall PI incidence was 37.3% (28.9% in prone and 8.4% in lateral positions). The most common sites were the iliac crest and flank. Significant predictors included intraoperative blood loss of 501–1,000 mL, which increased the risk by 2.6 times (Adjusted OR = 2.6, 95% CI: 1.0–6.4, p < .05), and the use of a carbon fiber frame (Allen® Advance Table), which increased the risk by 3.1 times compared to standard operating tables (Adjusted OR = 3.1, 95% CI: 1.5–6.5, p < .05). Conclusion: The incidence of PIs in this patient group was relatively high, with intraoperative blood loss and the type of operating table identified as significant influencing factors. Perioperative nurses should prioritize risk assessment at frequently affected anatomical sites and utilize appropriate pressure-redistributing devices to prevent the occurrence and minimize the severity of potential PIs.