Garber Susan L, Rintala Diana H
Houston Veterans Affairs Medical Center, Baylor College of Medicine, Houston, TX 77030, USA.
J Rehabil Res Dev. 2003 Sep-Oct;40(5):433-41. doi: 10.1682/jrrd.2003.09.0433.
Pressure ulcers are a major complication of spinal cord injury (SCI) and have a significant effect on general health and quality of life. The objectives of this retrospective chart review were to determine prevalence, duration, and severity of pressure ulcers in veterans with SCI and to identify predictors of (1) outcome in terms of healing without surgery, not healing, or referral for surgery; (2) number of visits veterans made to the SCI outpatient clinic or received from home care services for pressure ulcer treatment; and (3) number of hospital admissions and days hospitalized for pressure ulcer treatment. From a sampling frame of 553 veterans on the Houston Veterans Affairs Medical Center SCI roster, 215 (39%) were reported to have visited the clinic or received home care for pressure ulcers (ICD-9 code 707.0 = decubitus, any site) during the 3 years studied (1997, 1998, and 1999). From this sample, 102 veterans met the inclusion criteria for further analyses, 56% of whom had paraplegia. The duration of ulcers varied greatly from 1 week to the entire 3-year time-frame. Overall, Stage IV pressure ulcers were the most prevalent as the worst ulcer documented. Number and severity of ulcers predicted outcome and healthcare utilization. This study illustrates the magnitude of the pressure ulcer problem among veterans with SCI living in the community. Reducing the prevalence of pressure ulcers among veterans with SCI will have a significant impact on the Department of Veterans Affairs' financial and social resources. Innovative approaches are needed to reduce pressure ulcer risk in veterans with SCI.
压疮是脊髓损伤（SCI）的主要并发症，对总体健康和生活质量有重大影响。这项回顾性病历审查的目的是确定脊髓损伤退伍军人压疮的患病率、持续时间和严重程度，并确定以下方面的预测因素：（1）不通过手术愈合、未愈合或转介手术的结果；（2）退伍军人因压疮治疗到脊髓损伤门诊就诊或接受家庭护理服务的次数；（3）因压疮治疗住院的次数和天数。在休斯顿退伍军人事务医疗中心脊髓损伤登记册上的553名退伍军人样本中，据报告有215人（39%）在研究的3年（1997年、1998年和1999年）期间因压疮（国际疾病分类第九版代码707.0 = 褥疮，任何部位）到诊所就诊或接受家庭护理。从这个样本中，102名退伍军人符合进一步分析的纳入标准，其中56%患有截瘫。溃疡持续时间差异很大，从1周到整个3年时间框架不等。总体而言，IV期压疮作为记录的最严重溃疡最为普遍。溃疡的数量和严重程度可预测结果和医疗保健利用率。这项研究说明了社区中脊髓损伤退伍军人压疮问题的严重程度。降低脊髓损伤退伍军人压疮的患病率将对退伍军人事务部的财政和社会资源产生重大影响。需要创新方法来降低脊髓损伤退伍军人发生压疮的风险。
