Factors associated with the development of pressure ulcers after spinal cord injury

Eslami, Vahid; Saadat, Soheil; Arejan, Roya Habibi; Vaccaro, Alexander R.; Ghodsi, Seyed Mohammad; Rahimi‐Movaghar, Vafa

doi:10.1038/sc.2012.75

Cited by 40 publications

(49 citation statements)

References 18 publications

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“…Ten articles were identified that reported the prevalence or incidence of PUs in community dwellers from 6 months to 20 years after injury. [24][25][26][27][28][29][30][31][32][33] Of note, very few of these study subjects were reported to have undergone SCI rehabilitation. These 10 papers reported a PU prevalence of 26.7-46.2%, mean of 35.2%.…”

Section: Resultsmentioning

confidence: 99%

“…2,42 Because these healthcare providers lack SCI training, they struggle to manage PU risk factors in their patients and often fail to educate their patients about ongoing PU prevention strategies. In their letter to the editor responding to the 2012 study of PU risks in Iran by Eslami et al, 31 Rathore and Mansoor 43 note that 'lack of knowledge regarding PU prevention on the part of the doctors' is one of the 'four major reasons for PU occurrence' in Pakistan. Indeed, without access to specialty guidance, even the most educated and motivated person with SCI is prone to complications.…”

Section: Risk Factorsmentioning

confidence: 99%

“…39,40 In developing nations with comparatively low average educational level, this is also a significant barrier to care and a risk factor for SCI complications. 8,9,31,41 Educational deficiencies in these nations are twofold. First, people who suffer a SCI often have fewer years of education and poor health literacy.…”

Section: Risk Factorsmentioning

confidence: 99%

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Pressure ulcers in people with spinal cord injury in developing nations

2014

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Study design: Literature review. Objectives: To explore the prevalence or incidence, risk factors, and costs of pressure ulcers among individuals with spinal cord injury (SCI), specifically in the context of the developing world. To highlight important targets for intervention and research for pressure ulcer management the world over. Setting: World Bank 'low-income' and 'middle-income' countries with a gross national income per capita o$12 746. Methods: PubMed search. Results: SCI-associated pressure ulcers are very prevalent in developing nations; however, reported prevalence and incidence numbers are highly variable. Risk factors for pressure ulcers are similar in developed and developing countries however many of the risk factors are more prevalent in developing nations. Conclusion: SCI-associated pressure ulcers are common but can be prevented in the developing world. Key targets for interventions include acute care, nurse-to-patient ratios, support surfaces and education.

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Section: Resultsmentioning

confidence: 99%

Section: Risk Factorsmentioning

confidence: 99%

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Pressure ulcers in people with spinal cord injury in developing nations

2014

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“…Previous studies have reported age to be a risk factor for PU development. 21 Although previous studies have reported association between sex and development of PUs in individuals with SCI, 22 this study found no such association in both acute care hospitalization and inpatient rehabilitation. Individuals with AIS A were at increased risk to develop PUs than AIS C and AIS D, similar to previous studies.…”

Section: Discussionmentioning

confidence: 82%

Association between presence of pneumonia and pressure ulcer formation following traumatic spinal cord injury

Krishnan

Karg

Boninger

et al. 2016

The Journal of Spinal Cord Medicine

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A higher presence of pressure ulcers was found in individuals with pneumonia, after adjusting for injury severity, age, sex, and utilization of mechanical ventilation. Impaired inflammatory response and decreased mobility in individuals with pneumonia may predispose these individuals to develop pressure ulcers. Surveillance and preventive measures for pressure ulcers should be rigorous in individuals with SCI and pneumonia.

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“…[1][2][3] The incidence of TSCI ranges from 3.6 to 195.4 patients per million around the world 4 and 25.5 per million per year in developing countries. 5 A prerequisite to the development of effective therapies for TSCI is a detailed understanding of the pathophysiological events occurring after injury.…”

Section: Introductionmentioning

confidence: 99%

Potential variables affecting the quality of animal studies regarding pathophysiology of traumatic spinal cord injuries

et al. 2015

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Study design: This is a Delphi study. Objectives: Defining variables that potentially influence the outcomes of an animal study regarding pathophysiology of traumatic spinal cord injury (TSCI). Setting: This study was conducted in Iran. Methods: A modified two-round Delphi study was conducted. As the first round, an initial questionnaire was developed on the basis of literature and a series of focus group discussions. In the second round, the participants were asked to score the items through a 10-point scale. Consensus was achieved through the following criteria: (1) the median of scores has to be at 7.5 or higher, and (2) at least 70% of participants need to rate 7 or higher. Also, the inter-rater reliability analysis was performed to determine consistency among raters using the Kappa coefficient and Cronbach's alpha. Results: Twenty-one experts participated in our study. From the first round of the study, a 47-item checklist was developed. By considering the aforementioned criteria for consensus building on extremely important factors, we reached a 15-item checklist including species, strain, method and level of injury, control group, genetic background, severity of injury, attrition, use of appropriate test, blindness, method of allocation to treatments, regulation and ethics, age/weight, bladder expression, number of animals/group and statistics. The inter-rater reliability for the raters was found to be Kappa = 0.82 (Po0.001). A Cronbach's alpha of 0.9 for all the questions indicated high internal consistency. Conclusion: This study introduces a checklist of variables that potentially influence the outcomes of animal studies regarding TSCI pathophysiology and describe its validity and reliability. Spinal Cord (2016) 54, 579-583; doi:10.1038/sc.2015.215; published online 22 December 2015 INTRODUCTIONTraumatic spinal cord injury (TSCI) is a devastating injury to the patient, family and society, as a TSCI results in multi-system complications, impaired health-related quality of life and poor prognosis for neurologic recovery. 1-3 The incidence of TSCI ranges from 3.6 to 195.4 patients per million around the world 4 and 25.5 per million per year in developing countries. 5 A prerequisite to the development of effective therapies for TSCI is a detailed understanding of the pathophysiological events occurring after injury. The pathophysiology of TSCI can be well divided into two phases, a primary and a secondary injury. The primary injury involves the initial mechanical damage, which is followed by a delayed onset of a secondary phase comprising a cascade of molecular and cellular events that inhibits the regeneration and also extends the injured site. As a result of the many technical limitations associated with the study of TSCI pathophysiology in humans, almost all of our detailed understanding of TSCI pathophysiology is based on animal studies. Translation of the obtained outcomes to the clinic could be achieved through well-designed animal studies and consideration of the variables, which are decisive in det...

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Factors associated with the development of pressure ulcers after spinal cord injury

Abstract: SCI patients are a heterogeneous group and the risk factors associated with PU may vary in specific subgroups. Different models are needed to describe PU in SCI patients depending on the patient's age and the time passed since SCI.

Cited by 40 publications

References 18 publications

Pressure ulcers in people with spinal cord injury in developing nations

Pressure ulcers in people with spinal cord injury in developing nations

Association between presence of pneumonia and pressure ulcer formation following traumatic spinal cord injury

Potential variables affecting the quality of animal studies regarding pathophysiology of traumatic spinal cord injuries

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