Exploring the first pressure injury and characteristics of subsequent pressure injury accrual following spinal cord injury

The Journal of Spinal Cord Medicine, 2021 · DOI: 10.1080/10790268.2020.1744871 · Published: March 25, 2020

Spinal Cord Injury Rehabilitation Dermatology

Simple Explanation

This study looks at pressure injuries (also known as pressure ulcers) that develop after a spinal cord injury. It aims to understand what factors might lead to a person developing more pressure injuries after they've already had one. The research found that people with more severe spinal cord injuries (specifically, those with greater sensory and motor loss) were more likely to develop additional pressure injuries during their initial hospital stay. This information can help doctors and therapists better target prevention strategies for those at highest risk of developing further pressure injuries during their recovery.

Study Duration

2008 to 2012

Participants

38 adults with traumatic spinal cord injury who developed at least one pressure injury

Evidence Level

Not specified

Key Findings

1
Participants with ASIA D injury had a 67% decrease in the rate of additional pressure injury incidence compared to participants with ASIA A injury.
2
The severity of the first pressure injury had no significant association with subsequent pressure injury incidence.
3
Most participants’ first documented pressure injury was stage 2 severity (66%).

Research Summary

This study explored the characteristics of individuals who develop subsequent pressure injuries during acute care and inpatient rehabilitation following initial traumatic SCI. The results indicated that individuals with less severe sensory and motor loss had a decreased rate of developing subsequent pressure injuries. The study found that SCI severity (i.e. ASIA level) was significantly associated with developing subsequent pressure injuries during the index rehabilitation stay, although severity of the first pressure injury was not.

Practical Implications

Targeted Prevention Strategies

Clinicians should consider the degree of sensory and motor loss when educating patients and implementing prevention strategies for pressure injuries.

Focus on Acute Care

Given that most initial pressure injuries occur during acute care, increased attention should be given to prevention during this phase.

Further Research Needed

Future research should explore the relationship between pressure injury characteristics and subsequent pressure injury accrual with larger and more diverse samples.

Study Limitations

1
The majority of participants in our sample had ASIA A injury, which differs from the National Spinal Cord Injury Database wherein the majority of participants have incomplete injuries.
2
The sample size was small and relatively homogenous as data were obtained from one provider network in one geographic region.
3
This secondary analysis was limited to variables collected in the parent study, which prohibited the analysis of additional covariates, such as length of stay or other lifestyle factors

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