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探讨脊髓损伤后首次压力性损伤及其后续压力性损伤累积的特征。

Exploring the first pressure injury and characteristics of subsequent pressure injury accrual following spinal cord injury.

机构信息

Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Department of Rehabilitation Science & Technology, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

出版信息

J Spinal Cord Med. 2021 Nov;44(6):972-977. doi: 10.1080/10790268.2020.1744871. Epub 2020 Apr 1.

Abstract

Clinicians have guidance on prevention and treatment of pressure injuries, but little is known regarding characteristics of patients who develop additional pressure injuries. Thus, our objective was to explore the first pressure injury and characteristics of individuals who develop subsequent pressure injuries during acute care and inpatient rehabilitation following spinal cord injury. Secondary analysis of longitudinal data from a cohort of adults following initial traumatic spinal cord injury. Urban acute care hospital and inpatient rehabilitation facilities. A convenience sample of adults ( = 38) who developed at least one pressure injury during acute care and inpatient rehabilitation. Not applicable. The primary outcomes were number of additional pressure injuries and stage of care during which they occurred, prior to community discharge. A covariate-adjusted model revealed that participants with ASIA D injury had a 67% decrease in the rate of additional pressure injury incidence compared to participants with ASIA A injury (Rate Ratio = .33, 95% CI [0.13, 0.88]). The severity of the first pressure injury had no significant association with subsequent pressure injury incidence (= .10). These findings indicated that individuals with greater sensory and motor loss had an increased risk of developing additional pressure injuries compared to individuals with less impairment. These results are meaningful for stakeholders interested in understanding factors associated with developing subsequent pressure injuries during the index rehabilitation stay and provide a foundation for future research in this area.

摘要

临床医生有预防和治疗压力性损伤的指南,但对于在急性护理和脊髓损伤后住院康复期间发生额外压力性损伤的患者特征知之甚少。因此,我们的目的是探讨急性护理和住院康复期间首次发生压力性损伤以及随后发生压力性损伤的个体特征。这是一项对初始创伤性脊髓损伤后队列中成年人进行的纵向数据分析的二次分析。城市急性护理医院和住院康复设施。在急性护理和住院康复期间至少发生过一次压力性损伤的成年人(n=38)的方便样本。不适用。主要结局是在社区出院前额外压力性损伤的数量和发生时的护理阶段。调整协变量的模型显示,与 ASIA A 损伤的参与者相比,ASIA D 损伤的参与者发生额外压力性损伤的发生率降低了 67%(发生率比[RR] = .33,95%置信区间[0.13, 0.88])。首次压力性损伤的严重程度与随后发生压力性损伤的发生率无显著关联( = .10)。这些发现表明,与损伤程度较轻的个体相比,感觉和运动丧失程度较高的个体发生额外压力性损伤的风险增加。这些结果对于有兴趣了解与指数康复住院期间发生后续压力性损伤相关因素的利益相关者具有重要意义,并为该领域的未来研究奠定了基础。

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Impact of pressure ulcers on individuals living with a spinal cord injury.压疮对脊髓损伤患者的影响。
Arch Phys Med Rehabil. 2014 Dec;95(12):2312-9. doi: 10.1016/j.apmr.2014.08.003. Epub 2014 Aug 25.

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