Article

The aim of this study was to identify patient and clinical factors
most strongly associated with a spinal cord injury patient's risk for developing
a pressure ulcer (PU) during rehabilitation. DESIGN: This is a prospective
observational cohort study conducted at an urban rehabilitation hospital-based
specialized spinal cord injury center. The main outcome measure was the onset of
a stage 2 or higher PU. RESULTS: Study patients (N = 159) with new (n = 66) and
patients with earlier (n = 99) spinal injuries had identical rates at which they
acquired a new PU (stage >/=2) in rehabilitation--13.1%. 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%) than those who came to
rehabilitation without an existing PU or flap (6.9%). Logistic regression
analysis identified two variables that best predicted a patient's risk at
admission for developing a PU during rehabilitation (c = 0.77)--entering
rehabilitation with a PU and admission Functional Independence Measure transfers
score of less than 3.5. CONCLUSIONS: The greatest risk of developing a new PU in
rehabilitation is being admitted with an existing PU followed by admission
Functional Independence Measure transfers score of less than 3.5. Using these two
variables, one can develop a patient PU risk algorithm at admission that can
alert clinicians for the need to enhance vigilance, skin monitoring, and early
patient education.

Langue : ANGLAIS