Graduation Date

Fall 12-18-2020

Document Type


Degree Name

Doctor of Philosophy (PhD)



First Advisor

Janet Cuddigan

Second Advisor

Joyce Black

Third Advisor

Kevin Kupzyk

Fourth Advisor

Leeza Struwe


The purpose of this dissertation was to explore the strength of the relationship between unavoidable Hospital Acquired Pressure Injury (HAPI) and increased risk of one-year mortality for patients age 55 and older who were admitted to a hospital from 2015 to 2018. A quantitative, retrospective case-control study was designed to compare demographics, comorbid conditions, pressure injury risk, and living situation of those patients that developed unavoidable HAPI and hospitalized adults with similar physiological burdens that remained injury-free. The one-year mortality for the HAPI group was 27 of 48 (56%), and 26 of 47 patients (55%) for the Control group. The HAPI subjects were more likely admitted to the ICU (p = .005), had a longer length of ICU stay (p = .047), more orders for vasopressors (p < .001), greater use of vasopressors – norepinephrine (p = .017); epinephrine (p = .004), phenylephrine (p = .001), and a greater total number of vasopressors administered (p = .002). The discharge Braden Scale for Predicting Pressure Sore Risk total score (p = .002) and subscale scores for Sensory (p = .002), Activity (p = .022), Mobility (p = .019), and Friction/Shear (p < .001) were lower for the HAPI group. Discharge Braden Scale total score (p = .001) and subscale scores for Activity (p < .001), Mobility (p = .004), and Friction/Shear (p = .014) were lower for the HAPI subjects that died than those that survived beyond one year. The Area Under Receiver Operating Characteristics curve (AUROC) scores for the Charlson Comorbidity Index (CCI) were .655 (p = .006) for all patients, .753 (p < .001) for the Control group and .544 (p = .519) for the HAPI group. Further research is necessary to understand the effect of pressure injury on CCI scoring and determine the importance of discharge Braden Scale scores to identify those at increased risk of mortality.

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