Potentially modifiable risk factors among veterans with spinal cord injury hospitalized for severe pressure ulcers: a descriptive study

Guihan, Marylou; Bombardier, Charles H.

doi:10.1179/2045772312y.0000000016

Cited by 39 publications

(38 citation statements)

References 25 publications

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“…A general trend of development of pressure sore among people with low income was found in this study which was also common in the other reports [4,11,18,19]. Most of the respondents of this study had paraplegia (56.5%) and the principle cause was trauma which was similar to the report Rahman et al but Guihan et al reported most of their patients (73.3%) had complete spinal cord injury [10, 14,20] but in all the reports the major cause of injury was reported to be trauma whether road traffic accident or fall from height or any other mechanism of traumatic injury [4,10,11,14,20,21] ( Figure 1). Regarding the location, the authors found Buttock to be the predominant site for developing site pressure sore as evident form 67.5% patient had sore over their buttock followed by Ischial tuberosity (7.5%) and this finding was similar to Hossain et al and Ulrich et al reported the lower back to the commonest site for pressure sore [17,22] (Table 3).…”

Section: Discussionsupporting

confidence: 87%

“…Regarding the location, the authors found Buttock to be the predominant site for developing site pressure sore as evident form 67.5% patient had sore over their buttock followed by Ischial tuberosity (7.5%) and this finding was similar to Hossain et al and Ulrich et al reported the lower back to the commonest site for pressure sore [17,22] (Table 3). In this article 44.6% of the respondents had urinary complication and 16.9% had dysuria and 10.8% had urinary incontinence which is almost similar to the report of Thiyagarajan et al and Guihan et al [16,20] (Table 3). 30 patients with pressure sore had other skin disease which may be supported by the report of Guihan and Bombardier, where 96.2% patient had associated skin disease, but Endocrine conditions like Diabetes had a significant association whit development of pressure sore along with vascular conditions which were not evident in the current study [20].…”

Section: Discussionsupporting

confidence: 87%

“…The Demographic variables author took into consideration were sex, age, employment status and income of the patient. Out of 201 study population 176 were male and 25 were female and this male predominance was also reported in the previous studies carried out both locally [14,[18][19][20] and globally [4][5][6][7][8][9][10][11]21] (Table 1). In this study most of the patients were in their 3 rd decade which consisted 28.6% , followed by 27.4% in between 21-30 years and 26.8% in between 41-50, which was also a common finding as reported by Hossain et al [22] where mean age was 47.44 ± 13.30 [17]; Ulrich et al found it 36.1 and according to Lali et al [21] mean age was 35.3, but in some studies the age of the study population was little bit different [4,14,16,18] (Table 1).…”

Section: Discussionsupporting

confidence: 75%

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Demography, Diagnosis and Complications of Spinal Cord Injury Patients in a Rehabilitation Center of Bangladesh

Quadir¹,

Sen²,

Sultana³

et al. 2017

Int J Neurorehabilitation Eng

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IntroductionSpinal cord injury, is certainly a debilitating and devastating condition in terms of its effect on a person`s physical, mental, familial as well as social life [1]. Due to its profound impact on a person`s overall quality of life and increasingly high incidence, injury to spinal cord due to any pathology is now considered as a morbid condition as well as a threat to both personal and national economy [2,3]. Spinal cord injury itself is a crippling condition, at the same time may lead to a variety of complications which can affect the life of the patient as it increases the treatment cost significantly and accelerate the disease process which link to early mortality [1,3,4]. The incidence of Spinal cord injury is increasing throughout the world with an annual incidence rate of 15 to 40 per million with a male predominance, more prevalence in low socio-economic society and the causes ranges from traumatic in most of the case like motor vehicle accident to gunshot injury and physical violence, however non traumatic causes like Tuberculosis (TB) of the spine is also responsible for this [3][4][5][6]. A great variety of complications usually follow injury to spinal cord such as pressure sore, urinary complications, most of which are preventable nonetheless these associated complications are the most common cause of re-hospitalization following spinal cord injury and eventually lead to a great deal of disability, morbidity, degree of dependence and mortality [1][2][3][4].Spinal cord injury is a severe condition of the musculoskeletal system, more often leading to permanent disability and on the top of that brings about drastic changes the functioning ability of the patient and eventually encompassing each and every aspect of life [5][6][7][8]. Complications may associate virtually all systems of the body namely cardio-respiratory system, genitourinary system, local disorders like pressure sore or full blown biochemical disorders. Such domino effect following the injury to spinal cord significantly decreases the quality of life of the individual and happens on the early or acute stage when initial rehabilitation process are being initiated [6]. Spinal cord injury whether traumatic or form other cause and AbstractBackground: Spinal cord injury and its health related complications pose a major impact on the overall morbidity and mortality as well as cause economic constrains. It was aimed at looking into the demographic distribution, diagnosis, as well as complications in patients with spinal cord injury.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 75%

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Demography, Diagnosis and Complications of Spinal Cord Injury Patients in a Rehabilitation Center of Bangladesh

Quadir¹,

Sen²,

Sultana³

et al. 2017

Int J Neurorehabilitation Eng

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“…Specifically, individuals with a cervical injury reported significantly lower levels of depression than those individuals with thoracic level injuries. This is consistent with other findings in the literature 10,11,30 that may appear counterintuitive as clinicians often make the assumption that individuals with a higher level injury, and subsequently less function, will experience increased depression as compared to individuals who have retained more function. As clinicians try to identify which patients may be a risk for depression and poor outcomes postinjury, it is critical not to use level of injury or functional ability to assume degree of depression.…”

supporting

confidence: 88%

Identifying predictors of resilience at inpatient and 3-month post-spinal cord injury

Driver

Warren

Reynolds

et al. 2014

The Journal of Spinal Cord Medicine

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Objectives: To identify (1) changes in psychosocial factors, (2) relationships between psychosocial factors, and (3) significant predictors of resilience in adults with spinal cord injury (SCI) during inpatient rehabilitation and at 3-month post-discharge. Design: Cross sectional with convenience sample based on inclusion/exclusion criteria. Setting: Inpatient rehabilitation hospital and community-based follow-up. Participants: Individuals with a SCI. Interventions: Not applicable. Outcome measures: Demographic, resilience, self-efficacy for managing a chronic health issue, depression, social roles/activity limitations, and pain. Results: The final sample consisted of 44 respondents (16 women and 28 men). Results of repeated measure analyses of variance indicated no significant changes in variables between inpatient and 3-month follow-up. Bivariate correlations revealed associations between resilience and self-efficacy at inpatient (r = 0.54, P < 0.001), and resilience and depression (r = −0.69, P < 0.001) and self-efficacy (r = 0.67, P < 0.001) at 3-month follow-up. Hierarchical regression analyses a significant model predicting resilience at inpatient stay (R = 0.61; adjusted R 2 = 0.24, P = 0.023), and at 3-month follow-up (R = 0.83; adjusted R 2 = 0.49, P = 0.022). Self-efficacy was the strongest predictor at inpatient stay (β = 0.46, P = 0.006) and depression was strongest at 3-month follow-up (β = −0.80, P = 0.007). Conclusion: Results suggest that although resilience appears to be stable from inpatient to 3-month follow-up, different factors are stronger predictors of resilience across time. Based on current results, an assessment of self-efficacy during inpatient rehabilitation and an identification of depression at 3-month follow-up may be important factors to help identify those at risk of health issues overtime.

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“…The evolution of ischial tuberosity PrUs is often dramatic: in a study in veterans with chronic SCI hospitalized for PrUs, pelvic PrUs (including ischial tuberosity) were most frequently categorized as stage IV in 73% of cases, 34% of these ulcers were infected, and 40% had undermining of adjacent tissue. 5 In those cases, surgical reconstruction becomes the only available option. Different types of muscular flaps with varying degrees of vascularization and tissue layers can be chosen to match the type of wound and the defect type.…”

Section: Introductionmentioning

confidence: 99%

Lipofilling (fat grafting) in the secondary prevention of ischial tuberosity and pelvic pressure ulcers

Prévinaire

Opsomer

et al. 2015

Spinal Cord

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Study Design: Retrospective study. Objectives: Lipofilling was proposed to adult chronic spinal cord injury patients with history of ischial tuberosity pressure ulcers surgery, at risk of recurrence of pressure ulcers due to unsatisfactory adipose tissue thickness. Setting: Fondation Hopale, Berck, France. Methods: The three staged (Coleman) procedure for fat grafting consisted of water-jet assisted liposuction (Harvest-Jet), decantation, and reinjection of the autologous fat in three-dimensional plan. Results: Ten consecutive patients (eight paraplegics and two tetraplegics) benefited from bilateral ischial lipofilling, with additional lipofilling of the sacrum (three patients) and the trochanters (two patients). All patients attended the seating clinic with pressure mapping before and after lipofilling for appropriate cushion prescription. Mean follow-up time was 16 months (4-24 months). Complications were limited to stage I (two patients) and stage II (one patient) pressure ulcers, due to negligence. Excellent results with minimal fat wasting (between 10% and 25%) underneath the ischial tuberosity were seen in eight patients, with significant improvement of adipose tissue thickness. Total fat waste was seen in two patients, one of whom following dramatic weight loss. Results were always good in the sacrum and trochanteric areas. Lipofilling allowed longer sitting times (three patients), improved skin quality (nine patients), improved quality of life (six patients), 'a better feeling of positioning in their wheelchair' (four patients), and decrease in pelvic pain (three patients). Discussion and Conclusion: Pelvic lipofilling is safe, cost-effective, and can now be considered in the primary prevention of pelvic pressure ulcers in patients with insufficient adipose tissue.

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Potentially modifiable risk factors among veterans with spinal cord injury hospitalized for severe pressure ulcers: a descriptive study

Abstract: http://clinicaltrials.gov/ct2/show/NCT00105859.

Cited by 39 publications

References 25 publications

Demography, Diagnosis and Complications of Spinal Cord Injury Patients in a Rehabilitation Center of Bangladesh

Demography, Diagnosis and Complications of Spinal Cord Injury Patients in a Rehabilitation Center of Bangladesh

Identifying predictors of resilience at inpatient and 3-month post-spinal cord injury

Lipofilling (fat grafting) in the secondary prevention of ischial tuberosity and pelvic pressure ulcers

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