Article

OBJECTIVES: To determine the
occurrence and predictors for pressure ulcers in patients with spinal cord injury
(SCI) during primary in-patient rehabilitation.
SETTING: Eight Dutch
rehabilitation centres with specialized SCI units.
METHODS: The occurrence,
location and stage of pressure ulcers were registered between admission and start
of functional rehabilitation (called acute rehabilitation phase) and between
start of functional rehabilitation and discharge. Possible risk factors for the
occurrence of pressure ulcers during functional rehabilitation (personal and
lesion characteristics, complications and functional independence) were measured
at the start of functional rehabilitation and were entered as predictors in
univariate and multivariate logistic regression analysis with pressure ulcers
during functional rehabilitation as the dependent variable. RESULTS: Data for 193
patients (86%) were available. The occurrence of pressure ulcers, including stage
1, was 36.5% during acute rehabilitation phase and 39.4% during functional
rehabilitation. Most pressure ulcers were located at the sacrum (43%), followed
by heel (19%) and ischium (15%). The significant risk factors for pressure ulcers
during functional rehabilitation were motor completeness of the lesion,
tetraplegia, pressure ulcer during acute rehabilitation phase, pneumonia and/or
pulmonary disease, low score on the Functional Independence Measure (FIM)
self-care, continence, transfers, locomotion and total FIM motor score. Having
had a pressure ulcer during acute rehabilitation phase was the strongest risk
factor. CONCLUSION: The occurrence of pressure ulcers was comparable with other
studies. A few significant risk factors were found, of which having had a
pressure ulcer during acute rehabilitation phase being the strongest predictor.

Langue : ANGLAIS