MedStar Authors catalog › Details for: Factors associated with pressure ulcer risk in spinal cord injury rehabilitation.
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Factors associated with pressure ulcer risk in spinal cord injury rehabilitation.

by Hsieh, Ching Hui; Brown, Patrick; Bouchard, Tara; DeJong, Gerben.
Citation: American Journal of Physical Medicine & Rehabilitation. 93(11):971-86, 2014 Nov..Journal: American journal of physical medicine & rehabilitation / Association of Academic Physiatrists.ISSN: 0894-9115.Full author list: DeJong G; Hsieh CH; Brown P; Smout RJ; Horn SD; Ballard P; Bouchard T.UI/PMID: 24879551.Subject(s): Adult | Age Factors | Cohort Studies | Female | Follow-Up Studies | Hospitals, Urban | Humans | Incidence | Injury Severity Score | *Length of Stay | Male | Middle Aged | Physical Therapy Modalities | Predictive Value of Tests | *Preexisting Condition Coverage | *Pressure Ulcer/ep [Epidemiology] | Pressure Ulcer/pp [Physiopathology] | Prospective Studies | *Rehabilitation Centers | Risk Factors | Severity of Illness Index | Spinal Cord Injuries/di [Diagnosis] | *Spinal Cord Injuries/rh [Rehabilitation] | Spinal Cord Injuries/su [Surgery] | Treatment Outcome | Young AdultInstitution(s): MedStar Health Research Institute | MedStar National Rehabilitation NetworkActivity type: Journal Article.Medline article type(s): Journal Article | Observational Study | Research Support, U.S. Gov't, Non-P.H.SOnline resources: Click here to access online Digital Object Identifier: (Click here) Abbreviated citation: Am J Phys Med Rehabil. 93(11):971-86, 2014 Nov.Local Holdings: Available online from MWHC library: 1996 - present.Abstract: OBJECTIVE: The aim of this study was to identify patient and clinical factors most strongly associated with a spinal cord injury patient's risk for developing a pressure ulcer (PU) during rehabilitation.Abstract: DESIGN: This is a prospective observational cohort study conducted at an urban rehabilitation hospital-based specialized spinal cord injury center. The main outcome measure was the onset of a stage 2 or higher PU.Abstract: RESULTS: Study patients (N = 159) with new (n = 66) and patients with earlier (n = 99) spinal injuries had identical rates at which they acquired a new PU (stage >2) in rehabilitation--13.1%. The patients who came to rehabilitation with a PU or myocutaneous flap exhibited a higher rate of developing yet another PU while in rehabilitation (30.2%) than those who came to rehabilitation without an existing PU or flap (6.9%). Logistic regression analysis identified two variables that best predicted a patient's risk at admission for developing a PU during rehabilitation (c = 0.77)--entering rehabilitation with a PU and admission Functional Independence Measure transfers score of less than 3.5.Abstract: CONCLUSIONS: The greatest risk of developing a new PU in rehabilitation is being admitted with an existing PU followed by admission Functional Independence Measure transfers score of less than 3.5. Using these two variables, one can develop a patient PU risk algorithm at admission that can alert clinicians for the need to enhance vigilance, skin monitoring, and early patient education.

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