Turkish Journal of Physical Medicine and Rehabilitation 2010 , Vol 56 , Num 1

Prevalance and Risk Factors of Pressure Ulcers in Spinal Cord Injured Patients

Seçil Hıncal Boriçi 1 ,Ayşe Nur Bardak 2 ,Belgin Erhan 3 ,Berrin Gündüz 3 ,Özcan Seyyah 1
1 ‹stanbul Fizik Tedavi ve Rehabilitasyon Eğitim ve Arafltırma Hastanesi, ‹stanbul, Türkiye
2 İstanbul Fiziksel Tıp ve Rehabilitasyon Eğitim Araştırma Hastanesi, İstanbul, Türkiye
3 İstanbul Fiziksel Tedavi Rehabilitasyon Eğitim ve Araştırma Hastanesi, Fiziksel Tıp ve Rehabilitasyon Kliniği, İstanbul, Türkiye

Objective: Pressure ulcer (PU) is a frequent and important complication seen in patients with spinal cord injury (SCI). PU affects quality of life, and increases length of hospital stay and medical costs. This study aimed to evaluate PU frequency and the related factors in patients with SCI.

Materials and Methods: Ninety patients (67 male and 23 female) who were hospitalized between February 2007 and December 2008 were enrolled into the study. Demographic data, duration of injury, level and severity of injury, duration before rehabilitation, daily sitting time, history of pressure ulcers, duration and localization of ulcers, urinary-fecal incontinence, body mass index (BMI), and alcohol and tobacco consumption  of the patients were recorded. Total protein, albumin, hemoglobin and hematocrit levels were analyzed.

Results: The mean age of the patients was 36.9±13.5 years, the median time since injury was 5 months (3-95 month). The frequency rate of PU was 50%. There was no statistical difference between the patients with PU and without PU according to age, gender, educational level and daily sitting time. There was statistically significant association of PU with time intervals between injury onset and initiation of rehabilitation, daily duration of ambulation, BMI, and albumin levels. PU was common in patients with tetraplegia and complete lesion, fecal and urinary incontinence.

Conclusion: PU is a common complication of SCI. According to the results of this study, patients with tetraplegia and complete injuries, having urinary and fecal incontinence and low BMI are at risk for PU.  By starting rehabilitation at early stage, increasing the ambulation as much as possible and by regular assessment of serum albumin levels, the risk of PU might be reduced. 

Keywords : Spinal cord injury, pressure ulcer, risk factor, frequency