PREDICTORS OF PRESSURE ULCERS IN PATIENTS WITH SPINAL CORD INJURIES

1 , Zoran Bukumiric 2 , Aleksandra Karadžov Nikolic 3 , Rade Babovic 1 , Aleksandra Sekulic 1 , Srbislav Stevanovic 1 , Slobodan Jankovic 4 1 Klinika za rehabilitaciju "Dr M. Zotovic", Sokobanjaska 13 Beograd 2 ABSTRACT Introduction: Pressure ulcers (PUs) are often secondary complications in spinal cord injury (SCI) patients. Purpose: To investigate the presence and possible factors associated with pressure ulcers in SCI patients undergoing acute and functional rehabilitation. Methods: Th is was a retrospective study of 453 patients with SCI treated at the Clinic for Rehabilitation "Dr M. Zo- tovic", Belgrade, Serbia, between January 2000 and Decem- ber 2009. Factors that were tested for their infl uence on pres- sure ulcers in spinal cord injury patients included age, sex, mechanism of injury, neurological level of injury, complete- ness of injury, spasticity and length of stay. Th e presence and location of pressure ulcers were recorded on admission, dur- ing acute and functional rehabilitation and at discharge. Th e level of statistical signifi cance in our study was set to 0.05. Results: Th e study included 453 patients: 383 (84.5%) did not have a pressure ulcer during rehabilitation, and 70 (15.5%) patients had a pressure ulcer during rehabilita- tion. Of the total number of patients, 333 (73.5%) were male, and 120 (26.5%) were female. Th e average age of patients enrolled in the study was 51.8 ± 17.2 years. In a multiple lo- gistic regression model, one statistically signifi cant predictor of pressure ulcers during rehabilitation was pressure ulcer before rehabilitation (B = 1420, p <0.001), with an odds ratio (OR) = 4.1. Th is result shows that patients who had pressure ulcers on admission are 4 times more likely to regain pressure ulcers during rehabilitation after controlling for all of the fac- tors in the model. Another statistically signifi cant predictor of pressure ulcers during rehabilitation was FIM score on ad- mission (B = -0036, p = 0.015). Conclusion: Th e prevention of pressure ulcers in acute and functional rehabilitation increases functional outcomes in patients with SCI.