Factors Predicting Pressure Ulcers in Veterans with Spinal Cord Injuries

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Smith BM, Guihan M, LaVela SL, Garber SL: Factors predicting pressure ulcers in veterans with spinal cord injuries. Am J Phys Med Rehabil 2008;87:750–757.Objectives:To identify patient risk factors for pressure ulcers in a sample of veterans with spinal cord injuries and disorders.Design:A survey incorporating questions from the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System was mailed to individuals with spinal cord injuries and disorders in 2003. A multiple logistic regression model including 2574 respondents was used to examine the association between patient characteristics and the self-report of pressure ulcers.Results:Approximately 36% of respondents reported having pressure ulcers during the previous year. Respondent characteristics significantly associated with report of one or more pressure ulcers included diabetes (incidence rate ratio [IRR] = 1.36, P < 0.001), smoking (IRR = 1.16, P = 0.030), injury duration >30 yrs (IRR = 1.27, P = 0.000), and reporting frequent depressive symptoms (IRR = 1.30, P < 0.001). Veterans who did not have injuries related to their military service (IRR = 1.39, P < 0.001) or who received care at non-VA facilities in addition to or instead of VA facilities (IRR = 1.13, P = 0.024) were more likely than other veterans to report pressure ulcers.Conclusion:Efforts to prevent pressure ulcers should include increased attention to managing diabetes and depressive symptoms. Further research to explore the association between multiple healthcare system use and the risk of pressure ulcers should be pursued.

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