Predictive factors for pressure ulcers in the ambulatory stage of spinal cord injury patients

Abstract

Study Design: Case control study. Objective: To determine the main risk factors for pressure ulcer (PU) in ambulatory spinal cord injury (SCI) patients. Setting: Hospital del Trabajador, Santiago, (ACHS (Chilean Security Association), Chile. Methods: We studied 41 patients for traumatic SCI, from Santiago, Chile, cared for in our hospital. The clinical histories were reviewed from first discharge to 1996. The patients were categorized into two groups: 18 cases with a previous history of PU, and 23 patients with no history of PU were considered as controls. Univariate analysis was performed, 18 variables per case, 10 of which were psychosocial factors. Results: There were 37 men and four women. Average age was 41.7 years. Duration of SCI on average was 6.7 years. The distribution was complete paraplegia (CPP) 22 patients (54%), complete tetraplegia three patients (7%), incomplete paraplegia 11 patients (27%) and incomplete tetraplegia, five patients (12%). Four variables of the univariate analysis were significant: duration of cord injury (SCI time) 45 years, completeness of cord injury, paraplegia and not able to practice regular standing. There was a significant association in body morphology (endo or ectomorphic), being able to practice regular standing and personality disorder in CPP. Conclusions: The risk for developing PU was 4.3 times greater in CPP patients than is any other type of SCI. CPP patients who do not practice standing periodically, who have a personality disorder and have an ecto/endomorphic corporal morphology have a greater risk of suffering PU.

Risk factors for pressure ulceration in a resource constrained spinal injury service

“…Such manoeuvre has been reported to reduce the risk of pressure sores. 5,18 The improvement in prehospital care for spinal cord injured, and the provision of a national guideline for the treatment of the spinal cord injured may reduce incidence of pressure ulcer. Emphasis should be placed on early referral to specialised centres, better hospital patient flow, and training of specialist wound care nurses and provision of free nutritional supplements.…”

Engagement in occupational activities and pressure ulcer development in rehabilitated South Indian persons with spinal cord injury

“…Some of the major risk factors are decreased activity, immobility and low satisfaction with the activities of daily living. 3 PUs have a significant negative effect on the general health and quality of life of the patients. 3 The development of a PU affects the health and occupational status of an individual considerably.…”

The Continuity of Orthosis Use by Paraplegics which Had Been Prescribed During In-Patient Rehabilitation

“…Leg braces and assistive devices provide joint stability for joints that can not be moved voluntarily and when muscle strength is not sufficient to support upright posture during walking and standing in patients with SCI (2). Standing upright and therapeutic ambulation are useful for the trabecular bone (3), bowel, bladder function, digestion, sleep, well-being, pain, and fatigue (4) and also decrease the risk of pressure ulcers (5). The sensory input that arises from load-bearing on the lower extremity stimulates weak muscles that do not contribute to contraction during voluntary movement (2).…”