Markers for Pressure Injury Risk in Individuals with Chronic Spinal Cord Injury: A Pilot Study.

IF 1.7 4区医学 Q3 DERMATOLOGY

Advances in Skin & Wound Care Pub Date : 2025-03-01 Epub Date: 2025-01-27 DOI:10.1097/ASW.0000000000000253

Yi-Ting Tzen, Patricia T Champagne, Jijia Wang, Merrine Klakeel, Wei-Han Tan, Kath M Bogie, Timothy J Koh

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引用次数: 0

Abstract

Abstract:

Objective: To identify markers associated with pressure injury (PrI) history in individuals with spinal cord injury (SCI) using two approaches: skin blood flow (SBF) response toward localized heating, and serum marker for insulin resistance.

Methods: For this cross-sectional, observational study of adults with chronic traumatic SCI at T12 and above, researchers recruited two groups of participants: with history of PrI (group 1), and without history of PrI (group 2). The study protocol included obtaining fasting blood samples and measurement of SBF at bilateral heels with localized heating of 42 °C for 30 minutes from all participants. Primary SBF outcomes were initial peak and plateau SBF normalized to baseline SBF. The primary outcome for insulin resistance was Homeostatic Model Assessment for Insulin Resistance (HOMA-IR), calculated from fasting plasma glucose and insulin. Secondary outcomes included demographic and SCI information. Researchers used the Fisher exact test and Wilcoxon-Mann-Whitney test to compare the intergroup difference of categorical and continuous variables, respectively.

Results: Sixteen adults completed this study (group 1, n = 7; group 2, n = 9). In comparison with group 2, group 1 had significantly higher HOMA-IR (3.90 ± 0.71 vs 1.45 ± 0.71), suggesting higher insulin resistance, and longer duration of injury (22.54 ± 7.24 vs 7.98 ± 6.58 years). There were no between-group differences in SBF or other secondary outcomes.

Conclusions: HOMA-IR is a novel serum index associated with PrI history in persons with chronic SCI. Future longitudinal study is warranted to examine the role of insulin resistance in increasing PrI risk for the SCI population.

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慢性脊髓损伤患者压力损伤风险的标志物：一项初步研究

目的：通过皮肤血流量（SBF）对局部加热的反应和胰岛素抵抗的血清标志物两种方法，确定脊髓损伤（SCI）患者压力损伤（PrI）史的相关标志物。方法：对于T12及以上的成人慢性创伤性脊髓损伤的横断面观察性研究，研究人员招募了两组参与者：有PrI史的（1组）和没有PrI史的（2组）。研究方案包括从所有参与者中获取空腹血液样本和测量双侧脚跟SBF，局部加热42°C 30分钟。主要的SBF结果是初始峰值和平台SBF归一化到基线SBF。胰岛素抵抗的主要结局是胰岛素抵抗稳态模型评估（HOMA-IR），由空腹血糖和胰岛素计算。次要结局包括人口统计学和SCI信息。研究人员分别采用Fisher精确检验和Wilcoxon-Mann-Whitney检验比较分类变量和连续变量的组间差异。结果：16名成人完成了本研究(第一组，n = 7；与2组相比，1组患者HOMA-IR（3.90±0.71∶1.45±0.71）明显升高，提示胰岛素抵抗较高，损伤持续时间较长（22.54±7.24∶7.98±6.58年）。两组间在SBF或其他次要结局方面没有差异。结论：HOMA-IR是一种与慢性脊髓损伤患者PrI病史相关的新型血清指标。未来有必要进行纵向研究，以检验胰岛素抵抗在增加SCI人群PrI风险中的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in Skin & Wound Care DERMATOLOGY-NURSING

CiteScore

2.50

自引率

12.50%

发文量

271

审稿时长

>12 weeks

期刊介绍： A peer-reviewed, multidisciplinary journal, Advances in Skin & Wound Care is highly regarded for its unique balance of cutting-edge original research and practical clinical management articles on wounds and other problems of skin integrity. Each issue features CME/CE for physicians and nurses, the first journal in the field to regularly offer continuing education for both disciplines.