Pressure ulcer risk factors in persons with spinal cord injury Part 2: the chronic stage

• Published in: Spinal cord 2009-09, Vol.47 (9), p.651-661
• Main Authors: Gélis, A, Dupeyron, A, Legros, P, Benaïm, C, Pelissier, J, Fattal, C
• Format: Article
• Language: English
• Subjects: Age Factors; Anatomy; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Cerebrospinal fluid. Meninges. Spinal cord; Disability Evaluation; Female; Health Behavior; Hospitalization - statistics & numerical data; Human Physiology; Humans; Injuries of the nervous system and the skull. Diseases due to physical agents; Male; Medical sciences; Nervous system (semeiology, syndromes); Neurochemistry; Neurology; Neuropsychology; Neurosciences; Pressure Ulcer - epidemiology; Pressure Ulcer - etiology; Pressure Ulcer - prevention & control; review; Review Literature as Topic; Risk Factors; Sex Factors; Spinal Cord Injuries - complications; Spinal Cord Injuries - epidemiology; Traumas. Diseases due to physical agents
• ISSN: 1362-4393; 1476-5624
• DOI: 10.1038/sc.2009.32

Introduction: Pressure ulcers (PUs) are a common complication following spinal cord injury (SCI). Prevalence for persons in the chronic SCI stage varies between 15 and 30%. The risk assessment scales used nowadays were designed on pathophysiological concepts and are not SCI-specific. Recently, an epidemiological approach to PU risk factors has been proposed for designing an SCI-specific assessment tool. The first results seem quite disappointing, probably because of the level of evidence of the risk factors used. Objective: To determine PU risk factors correlated to the chronic stage of SCI. Materials and methods: Systematic review of the literature. Results: There are several PU risk factors for chronic SCI stage: socio-demographics, neurological, medical or behavioral. The level of evidence varies: it is quite high for the socio-demographics and neurological factors and low for behavioral factors. Discussion and conclusion: Behavioral risk factors (relieving the pressure, careful skin monitoring, smoking) are probably the ones for which a preventive strategy can be established. It is important to develop specific assessment tools for these behavioral risk factors to determine their relevance and evaluate the effect of therapeutic educational programs on persons with SCI.