Risk Factors for Early Occurring Pressure Ulcers... : American Journal of Physical Medicine & Rehabilitation (original) (raw)

Original Articles: PDF Only

Risk Factors for Early Occurring Pressure Ulcers Following Spinal Cord Injury

Anthony R. Mawson
Joseph J. Biundo
Pamela Neville
Hector A. Linares
Yvette Winchester
Alfredo Lopez

American Journal of Physical Medicine & Rehabilitation

67(3):p 123-127, June 1988.

We carried out a prospective study to determine the association between immobilization in the immediate postinjury period and the development of pressure ulcers in spinal cord-injured patients following their admission to Charity Hospital, New Orleans. Of 39 patients consecutively admitted to the hospital, 23 (59%) developed a grade one ulcer within 30 days, mostly in the sacral region (57%), the peak time of onset being day 4 postinjury (6/23 cases). In partial support of an earlier retrospective study (Linares HA, Mawson AR, Suarez E, Biundo JJ Jr: Association between pressure sores and immobilization in the immediate post-injury period. Orthopedics 1987;10:571-573), duration of unrelieved pressure prior to ward admission was significantly associated with ulcers developing within the first eight days of injury (_P_=0.04), but not with ulcers developing during the entire 30-day observation period (_P_=0.09). Time on the spinal board was also significantly associated with ulcers developing within 8 days (_P_=0.01), but not with ulcers developing within 30 days (_P_=0.09). An unexpected finding was the significant inverse association between systolic blood pressure and the development of ulcers both within 8 days (_P_=0.03) and within 30 days (_P_=0.02), suggesting that reduced tissue perfusion increases the spinal cord-injured patient's susceptibility to pressure ulcers.