Krause J S, Vines C L, Farley T L, Sniezek J, Coker J
Crawford Research Institute, Shepherd Center, Atlanta, GA 30309, USA.
Arch Phys Med Rehabil. 2001 Jan;82(1):107-13. doi: 10.1053/apmr.2001.18050.
To identify protective behaviors and risk factors associated with the development of pressure ulcers (PUs) after spinal cord injury (SCI).
A cross-sectional study to evaluate the relationship between protective behaviors and risk factors and 3 PU outcomes: a current PU, PUs within the past year, and ever hospitalized for a PU. Logistic regression was then used to identify the variables most strongly associated with PU outcomes.
Data were collected by case managers employed by the Arkansas Spinal Cord Commission, an agency that provides services to persons with SCI.
A total of 650 of 991 eligible individuals with SCI from a statewide population-based SCI registry participated. All ambulatory participants were eliminated, leaving 560 patients. Average age of the respondents was 27.2 years at injury (median age, 25yr) and 43.6 years at the time of the survey (median age, 42yr).
A 200-item interview was developed to measure a broad range of outcomes associated with SCI (including secondary conditions such as PUs), as well as risk and protective behaviors related to these outcomes.
Several characteristics and behaviors were related to PU outcomes. Being underweight (odds ratio [OR] = 2.18), having used medications to treat pain (OR = 1.33) or spasticity (OR = 1.31), having smoked at least 100 cigarettes over a lifetime (OR = 1.31), and being a current smoker (OR = 1.21) were associated with having a PU in the past year. Having completed a college degree (OR = 0.23), being married (OR = 0.49), and being currently employed (OR = 0.54) were associated with a lower risk of having a PU in the past year. Being underweight (OR = 1.94), having a history of incarceration (OR = 1.78), having attempted suicide (OR = 1.71), and reporting alcohol or drug treatment (OR = 1.65) were associated with having been hospitalized for a PU since injury. This study was unable to evaluate the efficacy of traditional health maintenance or protective behaviors for PUs, such as weight shifts or skin checks.
PUs are least likely to occur among individuals who maintain normal weight, return to a work and family role, and who do not have a history of tobacco use, suicidal behaviors, or self-reported incarcerations, or alcohol or drug abuse. Additional research is needed to identify better the risk factors for the occurrence of PUs.
确定与脊髓损伤（SCI）后压疮（PU）发生相关的保护行为和风险因素。
一项横断面研究，以评估保护行为和风险因素与3种压疮结局之间的关系：当前存在压疮、过去一年内发生过压疮、曾因压疮住院治疗。然后使用逻辑回归来确定与压疮结局最密切相关的变量。
数据由阿肯色州脊髓委员会雇佣的病例管理员收集，该机构为脊髓损伤患者提供服务。
来自全州基于人群的脊髓损伤登记处的991名符合条件的脊髓损伤个体中，共有650人参与。所有能行走的参与者均被排除，剩下560名患者。受访者受伤时的平均年龄为27.2岁（中位年龄25岁），调查时的平均年龄为43.6岁（中位年龄42岁）。
编制了一份包含200个条目的访谈问卷，以测量与脊髓损伤相关的广泛结局（包括压疮等继发性疾病），以及与这些结局相关的风险和保护行为。
若干特征和行为与压疮结局相关。体重过轻（比值比[OR]=2.18）、使用药物治疗疼痛（OR=1.33）或痉挛（OR=1.31）、一生中吸烟至少100支（OR=1.31）以及当前吸烟者（OR=1.21）与过去一年内发生压疮有关。完成大学学位（OR=0.23）、已婚（OR=0.49）以及目前有工作（OR=0.54）与过去一年内发生压疮的风险较低有关。体重过轻（OR=1.94）、有入狱史（OR=1.78）、曾尝试自杀（OR=1.71）以及报告接受过酒精或药物治疗（OR=1.65）与受伤后因压疮住院治疗有关。本研究无法评估传统的健康维护或针对压疮的保护行为（如体重转移或皮肤检查）的效果。
体重正常、回归工作和家庭角色、没有吸烟史、自杀行为史、自我报告的入狱史或酒精或药物滥用史的个体发生压疮的可能性最小。需要进一步研究以更好地确定压疮发生的风险因素。
