Article

OBJECTIVE: To identify the long-term clinical, individual, and social risk
factors for the development of pressure ulcers (PUs) in traumatic spinal
cord-injured persons with tetraplegia (TSCIt). DESIGN: Cohort survey with
self-applied questionnaires in 1995 and 2006.
SETTING: Thirty-five
French-speaking European physical medicine and rehabilitation centers
participating in the Tetrafigap surveys. PARTICIPANTS: Tetraplegic adults
(N=1641) were surveyed after an initial posttraumatic period of at least 2 years.
Eleven years later, a follow-up was done for 1327 TSCIt, among whom 221 had died
and 547 could be surveyed again. INTERVENTIONS: Not applicable. MAIN OUTCOME
MEASURES: The proportion of PUs documented at the various defined time points,
relative to the medical and social situations of the TSCIt, by using univariate
analyses followed by logistic regression. RESULTS: Of the participants, 73.4%
presented with a PU during at least 1 period after their injury. Four factors had
an effect on the occurrence of PUs in the long-term. Protective features for this
population were incomplete motor impairment (odds ratio, 0.5) and the ability to
walk (odds ratio, 0.2), whereas a strong predictive factor was the development of
a PU during the initial posttrauma phase (odds ratio, 2.7). Finally, a
significant situational factor was the lack of a social network (odds ratio,
3.1). CONCLUSIONS: We believe that the highlighting of a motor incomplete feature
of SCI (protective against the development of a PU) and of a medical risk factor,
an early PU (which served as a definitive marker of the trajectory of TSCIt),
together with a social situational factor, indicates the crucial role of initial
management and long-term follow-up.
CI - Copyright (c) 2017 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS