Salzberg C A, Byrne D W, Cayten C G, van Niewerburgh P, Murphy J G, Viehbeck M
Division of Plastic and Reconstructive Surgery, New York Medical College, Westchester County Medical Center, Valhalla, New York 10595, USA.
Am J Phys Med Rehabil. 1996 Mar-Apr;75(2):96-104. doi: 10.1097/00002060-199603000-00004.
Each year, one-fourth of the 200,000 individuals with spinal cord injury in the United States develop pressure ulcers. No method currently exists, however, to accurately identify which of these individuals are at increased risk for development of pressure ulcers. We studied 219 spinal cord-injured patients, seen at a Veterans Affairs Medical Center, during a 6-yr period. Our goal was to develop a pressure ulcer risk assessment scale, specifically for persons with SCI. Each risk factor had to meet four criteria: (1) statistical association with pressure ulcer development; (2) biologically plausible mechanism; (3) literature support; (4) improved prediction. Among the 219 spinal cord-injured patients evaluated, 176 (80.4 percent) had a history of one or more pressure ulcers. Fifteen risk factors met the four criteria for inclusion into the risk assessment scale. They were as follows: restricted activity level, degree of immobility, complete spinal cord injury, urinary disease, impaired cognitive function, diabetes, cigarette smoking, residence in a nursing home or hospital, hypoalbuminemia, and anemia. Compared with the more general scales available, for quantifying the risk of pressure ulcer development, preliminary results suggest that this new scale is a significant improvement for the spinal cord-disabled.
在美国，每年20万名脊髓损伤患者中有四分之一会发生压疮。然而，目前尚无方法能准确识别出这些患者中哪些人发生压疮的风险更高。我们对一家退伍军人事务医疗中心在6年期间接诊的219例脊髓损伤患者进行了研究。我们的目标是制定一个专门针对脊髓损伤患者的压疮风险评估量表。每个风险因素都必须满足四个标准：（1）与压疮发生存在统计学关联；（2）生物学上合理的机制；（3）有文献支持；（4）能改善预测。在评估的219例脊髓损伤患者中，176例（80.4%）有过一处或多处压疮病史。15个风险因素满足纳入风险评估量表的四个标准。它们如下：活动水平受限、不动程度、完全性脊髓损伤、泌尿系统疾病、认知功能受损、糖尿病、吸烟、居住在疗养院或医院、低白蛋白血症和贫血。与现有的更通用的量表相比，用于量化压疮发生风险的初步结果表明，这个新量表对脊髓损伤患者有显著改进。
