PREDICTORS OF PRESSURE ULCERS IN PATIENTS WITH SPINAL CORD INJURIES

Abstract

Introduction: Pressure ulcers (PUs) are common complications in patients with cord injury (SCI).

Purpose: To investigate the occurrence of pressure ulcers in patients with SCI during rehabilitation.

Methods: A retrospective study of 453 patients with the SCI admitted to the Clinic for Rehabilitation “Dr M. Zotovic”, Belgrade, Serbia, from January 2000 to December 2009. The factors that were tested for their influence on pressure ulcers in patients with spinal cord injury included: age, gender, mechanism of injury, neurological level of injury, completeness of injury, spasticity and length of stay. The occurrence and location of pressure ulcers were registered on admission, during the rehabilitation and at the discharge. The level of statistical significance in our study was set to 0.05.

Results: The study included 453 patients of whom 383 (84.5%) had a pressure ulcer during the rehabilitation and 70 (15.5%) patients had a pressure ulcer during rehabilitation. Out of the total number of patients 333 (73.5%) were male and 120 (26.5%) female. The average age of patients enrolled in the study was 51.8 ± 17.2 years. In a multiple logistic regression model, statistically significant predictor of pressure ulcers during rehabilitation is a variable pressure ulcer before rehabilitation (B = 1420, p <0.001) with the odds ratio OR = 4.1. This shows that patients who had pressure ulcers on admission are 4 times more likely to regain pressure ulcers during rehabilitation, with the control of all factors in the model. The statistically significant predictor of pressure ulcers during the rehabilitation is variable FIM score on admission (B = -0036, p = 0.015).

Conclusion: The prevention of pressure ulcers during rehabilitation shortens the stay in a rehabilitation centre and increases the functional outcomes in patients with SCI