Factors associated with pressure ulcer risk in spinal cord injury rehabilitation

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Study identified patient and clinical factors associated with the development of a stage 2 or higher pressure ulcer (PU) during spinal cord injury (SCI) rehabilitation. The 159 study patients, including 60 with new spinal injuries and 90 with earlier spinal injuries had identical rates at which they acquired a new PU (stage ≥2) in rehabilitation: 13.1 percent of the new SCI patients and 13.2 percent of the earlier SCI patients. The patients who came to rehabilitation with a PU or myocutaneous flap exhibited a higher rate of developing yet another PU while in rehabilitation (30.2 percent) than those who came to rehabilitation without an existing PU or flap (6.9 percent). Logistic regression analysis identified two variables that best predicted a patient’s risk at admission for developing a PU during rehabilitation: (1) entering rehabilitation with a PU and (2) admission Functional Independence Measure transfers score of less than 3.5. Using these two variables, rehabilitation centers can develop patient PU risk assessments to alert clinicians for the need to enhance vigilance, skin monitoring, and early patient education.

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