Nutrition
Poor nutrition has a significant role in PU development. Deficiencies can result from either decreased intake or malabsorption. Research indicates that the following factors increase the risk of developing a PU:

• malnutrition
• low levels of protein/albumin
• recent weight loss or morbid obesity
• specific deficiencies such as Vitamin C and zinc.

Demographics
Individual characteristics that appear to be associated with increased risk include:

• > 65 years of age
• male
• caucasian
• multiple co-morbidities
• previous history of PU injury, including reperfusion injury and those extending beyond the level of the dermis. 

Oxygen delivery
Decreased supply of oxygen to the area under stress leads to increased risk.  Risk conditions include:

• respiratory disorders
• cardiovascular impairment
• smoking
• autonomic dysfunction (as seen in spinal cord injury)
• fever or other conditions that lead to increased skin or core body temperature (every degree centigrade rise in temperature leads to a 10% increased demand for oxygen).

Chronic illness
The following conditions are also an increased risk of PU development:

• diabetes mellitus
• metastatic cancer
• renal impairment.

Pain
Pain can inhibit a patient’s movement.

Medications
Drugs can have a variety of effects including:

• decreased sensation
• drowsiness leading to decreased movement
• decreased inflammatory response
• decreased peripheral blood pressure.