Objective:To explore the risk factors of pressure injury (PI) in postoperative coma patients with severe brain injury (SBI) .Methods:From June 2018 to April 2022, 300 postoperative coma patients with SBI admitted to Henan Provincial People's Hospital were selected as the study subject by convenience sampling. Patients were divided into PI group ( n=35) and non-PI group ( n=265) based on whether PI occurred 7 days after surgery, and the clinical data of the two groups of patients were compared. Logistic regression was used to analyze the risk factors for postoperative PI in coma patients with SBI. Results:Among 300 postoperative coma patients with SBI, the incidence of PI during hospitalization was 11.67% (35/300), with a total of 54 occurrences of PI. Logistic regression analysis showed that age, diabetes, malnutrition, urinary and fecal incontinence, respiratory mode and postoperative hyperthermia were all the influencing factors of PI in coma patients with SBI after surgery ( P<0.05) . Conclusions:Age, diabetes, malnutrition, urinary and fecal incontinence, mechanical ventilation and postoperative high fever are all risk factors for PI in coma patients with SBI. Nurses should actively evaluate the risk of PI and provide targeted preventive measures.