Areg Grigorian MD, Megumi Sugimoto BS, Victor Joe MD, Sebastian Schubl MD, Michael Lekawa MD, Matthew Dolich MD, Eric Kuncir MD, Cristobal Barrios Jr. MD, Jeffry Nahmias MD, MHPE
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引用次数: 20
Abstract
Background
In a systematic review, the level of spinal cord injury (SCI) was not associated with risk for pressure ulcer (PU). We hypothesized that in the acute trauma population, upper-SCI (cervical/thoracic) has greater risk for PU when compared to lower-SCI (lumbar/sacral). We additionally sought to identify risk factors for development of PUs in trauma.
Methods
A retrospective analysis of the NTDB (2007–2015) was performed. Covariates were included in a multivariable logistic regression analysis to determine risk for PU.
Results
Of 62,929 patients (0.9%) with SCI, most had an upper-SCI (83%). The overall rate of PUs in patients with SCI was 5.1%. More patients with upper-SCI developed PUs compared to lower-SCI (5.8% vs. 2.2%, p < 0.001). SCI was the strongest predictor for PU (OR = 13.77, CI = 13.25–14.31, p < 0.001). Upper-SCI demonstrated greater risk compared to lower-SCI (OR = 2.81, CI = 2.45–3.22, p < 0.001).
Conclusions
Contrary to previous reports, a higher SCI level is associated with a three-fold greater risk for PU compared to lower SCI.
在一项系统综述中，脊髓损伤(SCI)的水平与压疮(PU)的风险无关。我们假设，在急性创伤人群中，上段脊髓损伤(颈椎/胸椎)比下段脊髓损伤(腰椎/骶骨)有更大的PU风险。我们还试图确定创伤脓毒症发展的危险因素。方法对2007-2015年NTDB病例进行回顾性分析。协变量包括在多变量逻辑回归分析中，以确定PU的风险。结果在62,929例(0.9%)脊髓损伤患者中，大多数为上肢脊髓损伤(83%)。脊髓损伤患者脓毒症的总体发生率为5.1%。上肢脊髓损伤患者出现脓肿的比例高于下肢脊髓损伤患者(5.8% vs. 2.2%， p <0.001)。SCI是PU的最强预测因子(OR = 13.77, CI = 13.25-14.31, p <0.001)。上脊髓损伤的风险高于下脊髓损伤(OR = 2.81, CI = 2.45-3.22, p <0.001)。与之前的报道相反，较高的脊髓损伤水平与较低的脊髓损伤相比，PU的风险增加了三倍。
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