Pressure Injury Calculator

*Pressure injuries are open sores in pressure areas, such as your tailbone, ischium, heel, and elbows. They are usually caused by pressure but may also be caused by friction or shearing (rubbing), moisture, burns, or falls.

What is your risk?

The probability of you having at least one pressure injury within the next 12 months:

Is this low, moderate, or high risk?

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What behavioral factors, medications, tobacco, and exercise are raising the risk of pressure injury?

How the individual uses medications and cigarettes, diet, and physical activity level:

How often is prescription medication used to treat conditions:

What other factors are related to the risk of pressure injuries:

What is the risk?

10%

How does this risk compare with others?

Ratio:

Min

Max

The respondent’s risk
Average risk

Min & Max: This places the individuals risk of at least 1 ED hospitalization in the next 12 months in the context of the average of all individuals with the same walking status, as walking status is highly related to pressure injuries. The minimum represents the lowest possible score for that walking status based on low-risk responses to the question; whereas the maximum score represents the highest possible score based on high-risk responses to the questions.

Low risk: includes all people who have a risk score of less than one half of standard deviation below the mean.
Moderate risk: includes all people who fall within one half of a standard deviation below or above the mean.
High risk: represents all people one half standard deviation or more above the mean.

Note:Healthcare providers should keep in mind that average risk is not typically the desired level of risk. People who have average risk are still at risk for pressure injuries. This is why those who are within one half standard deviation below the mean are still considered moderate risk. The goal is to reduce risk to an acceptable level.

Cut-off points for low, moderate, and high risks
Risk level	Low Risk	Moderate Risk	High Risk
Percentage	< 23.69%	23.69% - 42.54%	> 42.54%

■ The respondent’s risk category

What behavioral factors, medications, tobacco, and exercise are raising the risk of pressure injuries?

How the individual uses medications and cigarettes, diet, and physical activity level:

How often is prescription medication used to treat conditions:

What other factors are related to the risk of pressure injuries:

Important note to user: The calculator cannot differentiate the extent to which the increased risk of pressure injuries relates to the medication per se versus the underlying condition. The percentage of added risk associated with each of the risk variables related to how the individual uses medications and alcohol and the frequency of use of prescription medication to treat conditions relate to each specific factor, holding all other things equal. It gives the relative importance of each factor. In unusual circumstances where individuals have a very large number of risk factors, the individual percentages may exceed the total risk probability of the pressure injury. Therefore, the percentage of increased risk for each factor needs to be considered as a general indicator of risk. Race-Ethnicity is also realted to pressure injuries and other important outcomes.

This is a tool to help you understand the risk of having a pressure injury in the next 12 months among people with spinal cord injury (SCI).

This tool is based on our cross-sectional study of 4670 people with SCI. Since those with SCI have a higher rate of pressure injuries and hospitalizations, our purpose was to identify the various predictors of pressure injuries and hospitalizations among individuals with SCI. This calculator shows the probability of having at least one pressure injury and ED related hospitalization in a 12-month time frame. This is based on identifying how other people with SCI who have answered the same basic questions. Because the data were collected at a single point in time, we cannot determine cause and effect.

The estimates are based on our research give a general idea of risk and what places people with SCI at risk for pressure injuries. They will help people see how likely, they are on average, to have an pressure injury and ED related hospitalization based on number of factors, including health behaviors, demographics, and injury level. Because findings vary from study to study, the estimates are only to give a general idea of an individual’s risk compared to that of others with similar characteristics. It also will help people to see how they can reduce their risk of pressure injuries.

Our Emergency Department Calculator used the following factors:
1. Sex (Male, Female)
2. Current age
3. Years post-injury
4. Walking status
5. SCI neurological level
6. Race/ethnicity, we use a combination of race-ethnicity and because of limitations in our data, it is analyzed in three groups: non-Hispanic White, non-Hispanic Black, and Other, which includes Hispanic, Asian, Native Hawaiian, Pacific Islander, American Indian, Alaskan Native. We use the “other” category because there were not enough participants in any group, other than non-Hispanic White and non-Hispanic Black, to form individual categories.
7. Household income
8. Weight status
9. Diet
10. Alcohol misuse
11. Non-medical substance misuse
12. Frequency of prescription medication usage
13. Prescription medication misuse
14. Cigarette smoking
15. Exercise

Source of data: A description of the data upon which the calculators are based are reported in a study of emergency department visits (Cao, DiPiro, & Krause, under review)

Calculator limitations:
There are factors that relate to risk of pressure injuries and ED related hospitalizations that are not accounted for within this formula. We are unable to include other factors because we have used findings from a single study.

DISCLAIMER: Your risk of an pressure injury or ED related hospitalization may relate to your health condition or your medications you are taking to treat the condition. Talk with your doctor or healthcare provider before making any changes to your use of medications.

This calculator is only intended to be one tool to help you understand how certain factors relate to pressure injuries and ED related hospitalizations. You should NEVER base healthcare or other important decisions solely on individualized calculators or other types of printed or online materials. You should consult your doctor or other healthcare provider if you have questions or concerns regarding your health.

Reference:
Cao, Y., DiPiro, N.D., & Krause, J.S. (under review). Emergency department visits and related hospitalizations after traumatic spinal cord injury. Spinal Cord.