Pressure Ulcer Risk Factors in Persons with Mobility-Related Disabilities

Abstract

OBJECTIVE To assess pressure ulcer (PU) risk in persons with mobility impairments using a large data set to identify demographic, laboratory, hemodynamic, and pharmacologic risk factors. METHODS The cohort of interest was persons with disabilities who have mobility impairments and are diagnostically at risk of PUs. To define this cohort, diagnoses that qualify patients for skin protection wheelchair cushions were used. Data were obtained from the Cerner Health Facts data warehouse. Two cohorts were defined: persons with and without a history of PUs. Analysis included descriptive statistics and multivariate logistic regression modeling. Variables retained in the model were identified using LASSO, gradient boosting, and Bayesian model averaging. MAIN RESULTS The resulting cohorts included more than 87,000 persons with a history of PUs and more than 1.1 million persons who did not have a PU. The data revealed seven disability groups with the greatest prevalence of PUs: those with Alzheimer disease, cerebral palsy, hemiplegia, multiple sclerosis, paraplegia/quadriplegia, Parkinson disease, and spina bifida. Ulcers in the pelvic region accounted for 82% of PUs. Persons with disabilities who were male or black had a greater prevalence of PUs. Physiologic risk factors included the presence of kidney or renal disease, decreased serum albumin, and increased serum C-reactive protein. CONCLUSIONS The results indicate that, although persons with disabilities can exhibit a wide functional range, they remain at risk of PUs and should be evaluated for proper preventive measures, including support surfaces and wheelchair cushions.

Using Machine Learning Technologies in Pressure Injury Management: Systematic Review

“…The articles that were included in our analysis were published between 2007 and 2020 and were undertaken in the United States [25][26][27][28][29][30][31][32][33][34][35], China [36][37][38][39][40][41][42][43][44], Spain [45][46][47][48][49][50], Japan [51,52], Italy [53,54], Korea [55], and Greece [56]. According to the applied area of the included studies, we divided the articles into three components: predictive model (12 studies), posture recognition (11 studies), and image analysis (9 studies).…”

Analysis of epidemiological characteristics and surgical treatment of patients with pressure ulcer

“…Most often these injuries were caused by traffic trauma, while war trauma appears as a cause in a negligible number of cases. However, previous studies stated that after World War II, increase of pressure ulcers of 85% was recorded among war veterans [1,12,13]. There were three times more male patients injured in traffic accidents than female ones (75% vs. 25%).…”

“…There are also certain publications discussing unusual instances of pressure ulcers such as toes and shanks occurring due to prolonged usage of compression stockings, but also vulva, perineum and scrotum. [2,8,12,13] Pressure ulcer care is a complex, long and slow process. First of all, pressure must be relieved or removed by appropriate measures to prevent further injury.…”

Role of microRNAs in Pressure Ulcer Immune Response, Pathogenesis, and Treatment

“…Most often seen at sites overlying bony prominences, pressure injury occurs when external forces on the skin and soft tissue ultimately result in internal damage and skin ulceration; however, the physiologic derangements leading to wound formation are complex and multifactorial [5,7]. Patient populations with decreased mobility are at particular risk of pressure injury due to prolonged mechanical force during periods of static positioning, including patients with spinal cord injury as well as patients undergoing prolonged operations [4][5][6]11].…”