Predictors of Pressure Ulcer Recurrence in Veterans With Spinal Cord Injury

J Spinal Cord Med, 2008 · DOI: · Published: January 1, 2008

Spinal Cord Injury Rehabilitation Dermatology

Simple Explanation

Pressure ulcers (PrUs) are a significant concern for individuals with spinal cord injuries (SCI) due to factors like lack of sensation and immobility, making them more susceptible to developing these ulcers. Recurrent ulcers are common and costly, but limited evidence exists to guide clinical management. This study aimed to identify predictors of PrU recurrence in veterans with SCI who had been hospitalized for severe pelvic PrUs and were healed upon discharge. The research sought to understand which factors contribute to the re-emergence of these ulcers in this high-risk population. The study revealed that African American race, higher scores on the Charlson Co-Morbidity Index (indicating a higher burden of illness), the Salzburg PrU Risk Assessment Scales, and longer sitting time at discharge were significant predictors of PrU recurrence in this veteran population.

Study Duration

November 2003 and follow-up ended in June 2005

Participants

64 veterans with healed PrUs

Evidence Level

Cross-sectional observational design

Key Findings

1
African American race was identified as the strongest predictor of pressure ulcer recurrence in veterans with spinal cord injury.
2
Higher scores on the Charlson Co-Morbidity Index, indicating a greater burden of illness, were associated with an increased risk of pressure ulcer recurrence.
3
Longer sitting time at discharge from the hospital was found to be a significant predictor of pressure ulcer recurrence.

Research Summary

This study investigated factors predicting pressure ulcer (PrU) recurrence in veterans with spinal cord injury (SCI). Data were collected from 64 veterans with healed stage III/IV pelvic PrUs across six VA SCI centers. The study found that African American race, higher comorbidity scores (Charlson Index), higher Salzburg Risk Assessment scores, and longer sitting time at discharge were significant predictors of PrU recurrence. The authors conclude that identifying high-risk individuals and developing effective prevention programs are essential. They recommend considering the findings preliminary until replication is published.

Practical Implications

Targeted Prevention Programs

Develop tailored prevention programs focusing on modifiable risk factors such as managing comorbid conditions and optimizing sitting time, particularly for high-risk individuals.

Early Skin Assessment

Implement improved methods for early identification of skin breakdown, especially in individuals with darkly pigmented skin, to address the challenges in visually detecting erythema.

Further Research

Conduct further research to explore the relationship between sitting time and recurrence, as well as to identify other potential factors contributing to recurrence in specific populations.

Study Limitations

1
The study is based on a small cross-sectional sample, which may limit the generalizability of the findings.
2
The sample size might have limited the ability to detect differences in certain risk factors.
3
The exploratory nature of the study suggests the findings should be considered preliminary until replication.

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