Pressure ulcers and the challenge with current methods
Pressure ulcers (also called bedsores) are painful wounds that develop when prolonged pressure on the skin cuts off blood flow. They affect around 700,000 people in the UK each year, including 1 in 20 hospital patients and cause suffering, extend hospital stays, and cost the NHS £3.8 million every day. Up to 95% of pressure ulcers can be prevented with regular repositioning, special mattresses, and good nutrition. The challenge is to identify at-risk patients early enough.
Nurses use checklists to assess pressure ulcer risk. These are helpful, but have limitations. They might overlook important medical conditions that affect a patient’s mobility or sensation or changes in a patient’s condition that occur during their hospital stay. As a consequence, some high-risk patients don’t receive preventive care soon enough, whilst other low-risk patients receive unnecessary interventions.
What this research project will do
Our team at Imperial College London has developed a tool that uses machine learning, a type of artificial intelligence, to predict pressure ulcer risk more accurately. It analyses information that hospitals routinely, collect, such as age, blood test results, and pre-existing medical conditions and identifies patterns in this information that are difficult for humans to spot
However, before this tool can be used to help patients, we need to check that it works equally well in other hospitals. This study will test whether our tool performs accurately when applied to patient data from hospitals in the East of England. We will compare patients who developed pressure ulcers with those who did not, to verify that the tool correctly identifies high-risk individuals.
What information we need
We will use anonymised hospital records from adult patients (18 years and older) who stayed in hospital for at least 24 hours between 2017 and 2024. The information we need includes basic demographics (age and gender), vital signs (pulse, blood pressure, breathing rate), blood test results (such as haemoglobin and kidney function), medications prescribed, and pre-existing medical conditions (like diabetes or spinal cord injury). All of this information has already been collected as part of routine hospital care. There is no need to access personal identifiers (names, addresses, NHS numbers).
How this research will benefit patients and the NHS
If our tool works well in East of England hospitals, it will drive the development of a tool that could be used in hospitals to help healthcare teams identify high-risk patients within hours of admission, allowing preventive care to begin immediately. This would hopefully reduce the number of patients who develop painful pressure ulcers, shorten hospital stays, and save NHS resources. The tool would work automatically in the background, using information that hospitals already collect, without requiring extra work from busy nursing staff.
Project ID
SDE_EE_PROJ_A0025
Project start date
1 February 2026
Project end date
1 March 2027
Lead applicant:
Dr Mikael SodergrenProject team:
| Name | Job title | Organisation |
|---|---|---|
| Dr Simon Erridge | Postgraduate Researcher | Imperial College London |
| Dr Pedro Mediano | Lecturer | Imperial College London |
| Dr Stuart Bowyer | Assistant Professor | Imperial College London |
Date of countersigned contract
20 January 2026
Health Research Classification System (HRCS) Category
- Blood
- Skin
- Non health
Is this project a multiple-SDE project?
No
Is Eastern SDE the lead SDE?
Not applicable
Name of SDE parties
- Not applicable
Are patients involved?
Stages of Public Involvement in this Study:
Designing the Research Project:Members with lived experience of pressure injuries (as either individual or carers), have been invited to partner with the research team and join a PPIE advisory panel. This will ensure the proposed research is aligned with the needs, preferences and experiences of individuals affected by pressure injuries.
The PPIE advisory panel is formed of 6 members. This includes 2 each from an established PPIE advisory panel based at the clinical trials unit at the University of Leeds “Pressure Ulcer Research Service User Network (PURSUN)” and a similar advisory panel which is currently being established at the Royal College of Surgeons in Ireland. Finally, two individuals with lived experience in pressure ulcer from North West London make up the final members of the panel. This is to promote diverse representation in perspectives, needs and experiences of PPIE members. This is particularly important considering the existing ethnic, age, and skin tone disparities in individuals affected by pressure injuries.
Members of the PPIE advisory panel will have an active involvement in decision making during this proposed project, and together, we will identify the most relevant outcome measures when developing a clinical prediction tool from large data, alongside ethical use of data. They will also be involved in helping design the parameters for assessment of data accuracy and determining what is an acceptable standard of accuracy.
Participants will be reimbursed for their time in accordance with NIHR guidance on funding for contribution to PPIE. We have identified specific funding streams to support this work, should the research be approved.
Managing the Research Project:The PPIE advisory panel plans to hold our first meeting this summer and will provide ongoing input and ensure the research remains patient centred.
This group will meet bi-monthly during the research to ensure this.
Analysing the Data:The PPIE advisory panel will be involved in decisions about the study outcomes, particularly to critically appraise the accuracy of clinical prediction determined utilising this approach to ensure this is meaningful and relevant to patients.
Disseminating the Study Results: We will seek advice from the PPIE advisory panel on the best channels to sharing the research findings with diverse audiences. This approach ensures that the study results are communicated not only through academic outlets, such as publications and conferences, but also reach local communities and public through accessible, plain language summaries, various media platforms, and broad dissemination efforts.How will the results be published?
Public benefit statement
Data variables required
Secondary care data available from East of England SDE including age, blood test results, blood pressure readings and pre-existing medical conditions.
Cohort size
300000
Criteria
Adult patients (≥18 years) with inpatient admissions ≥ 24 hours across EoE SDE participating trusts. Cohort Definition: Adult patients (≥18 years) with inpatient admissions ≥ 24 hours across EoE SDE participating trusts who develop a hospital-acquired pressure ulcer during the admission, identified using ICD-10 diagnostic codes (L89) and SNOMED CT codes (where appropriate). Assessment of whether the pressure ulcer was hospital acquired will be conducted through ensuring the date of clinical coding of pressure ulcer is ≥24 hours to the date of admission. This will be used to compare individuals who develop a hospital-acquired pressure ulcer and those who do not. Control Definition: Adult patients (≥18 years) with inpatient admissions ≥ 24 hours across EoE SDE participating trusts who do not have a hospital-acquired definition in accordance with the definition provided for the cohort of interest.