Prevalence, location, grade of pressure ulcers and association with specific patient characteristics in adult spinal cord injury patients during the hospital stay: a prospective cohort study

Scheel‐Sailer, Anke; Wyss, Adrian; Boldt, Christine; Post, Marcel W.M.; Lay, Veronika

doi:10.1038/sc.2013.91

Cited by 87 publications

(73 citation statements)

References 17 publications

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“…3 In the literature, prevalence rates of pressure ulcers vary due to differences in study methodology, but more recent studies suggest that between 25 and 50% of veterans with SCI are estimated to receive treatment for pressure ulcers. [3][4][5] Pressure ulcers not only pose a significant medical burden, but they also are associated with high costs of care. The annual cost of treating pressure ulcers in the SCI population has been projected to be $1.3 billion.…”

Section: Introductionmentioning

confidence: 99%

Bacteriology of pressure ulcers in individuals with spinal cord injury: What we know and what we should know

Dana

Bauman

2014

The Journal of Spinal Cord Medicine

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Individuals with spinal cord injury (SCI) are at increased risk for the development of pressure ulcers. These chronic wounds are debilitating and contribute to prolonged hospitalization and worse medical outcome. However, the species of bacteria and the role that specific species may play in delaying the healing of chronic pressure ulcers in the SCI population has not been well characterized. This study will review the literature regarding what is known currently about the bacteriology of pressure ulcers in individuals with SCI. An electronic literature search of MEDLINE (1966 to February 2014) was performed. Eleven studies detailing bacterial cultures of pressure ulcers in the SCI population met inclusion criteria and were selected for review. Among these studies, bacterial cultures were often polymicrobial with both aerobic and anaerobic bacteria identified with culture techniques that varied significantly. The most common organisms identified in pressure ulcers were Staphylococcus aureus, Proteus mirabilis, Pseudomonas aeruginosa, and Enterococcus faecalis. In general, wounds were poorly characterized with minimal to no physical description and/or location provided. Our present understanding of factors that may alter the microbiome of pressure ulcers in individuals with SCI is quite rudimentary, at best. Well-designed studies are needed to assess appropriate wound culture technique, the impact of bacterial composition on wound healing, development of infection, and the optimum medical and surgical approaches to wound care.

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Section: Introductionmentioning

confidence: 99%

Bacteriology of pressure ulcers in individuals with spinal cord injury: What we know and what we should know

Dana

Bauman

2014

The Journal of Spinal Cord Medicine

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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: 90%

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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“…Data on occurrence, localisation and risk factors of PU have been reported in a previous article in this journal using the same database. 2 In addition, the current paper contributes a longitudinal perspective, analysing time until occurrence and time until closure of PU.…”

Section: Methodsmentioning

confidence: 99%

“…[1][2][3] Although many in-patient prevention concepts have been developed, being admitted to a hospital or rehabilitation centre is still a risk factor for hospital-acquired pressure ulcers (HAPUs). 4 HAPUs are associated with high hospital costs because of prolonged hospital stay 5 and need for additional materials and nursing time.…”

Section: Introductionmentioning

confidence: 99%

Hospital-acquired pressure ulcers in spinal cord injured patients: time to occur, time until closure and risk factors

et al. 2016

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Study design: Prospective observational cohort study. Objectives: To describe time to occur and time until closure of hospital-acquired pressure ulcers (HAPUs) in patients with spinal cord injury (SCI). Setting: Specialised SCI acute care and rehabilitation clinic in Switzerland. Methods: Daily registration of the presence and severity of HAPUs in a consecutive sample of SCI patients during their entire in-patient stay. Results: Out of 185 observed SCI patients, 55 patients (29.7%) developed at least one HAPU. Within the first 30 days after admission, 50% of all HAPUs occurred. Less severe HAPUs occurred earlier than severe HAPUs. The occurrence of HAPUs was significantly associated with reason of admission (Po0.01), and was highest in first rehabilitation (51.4%) and orthopaedic surgery patients (41.4%). The incidences of first HAPU in these groups were 1.04 and 2.31 per patient-year, respectively. Patients in first rehabilitation or readmitted because of pressure ulcer (PU) showed an initial lower risk for HAPUs in the Kaplan-Meier curve compared with patients readmitted for other reasons. Cox regression analysis revealed an association between longer time since SCI and time until occurrence (P = 0.01). Closure of the HAPUs during hospitalisation was observed in 37 patients (67.3%) after 38.9 days on average. No significant associations were found between patient characteristics and time until closure. Conclusion: The dynamics of HAPUs varied according to admission reason and time since lesion. However, ongoing awareness to prevent HAPUs is needed in all patients with SCI.

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Prevalence, location, grade of pressure ulcers and association with specific patient characteristics in adult spinal cord injury patients during the hospital stay: a prospective cohort study

Cited by 87 publications

References 17 publications

Bacteriology of pressure ulcers in individuals with spinal cord injury: What we know and what we should know

Bacteriology of pressure ulcers in individuals with spinal cord injury: What we know and what we should know

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

Hospital-acquired pressure ulcers in spinal cord injured patients: time to occur, time until closure and risk factors

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