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Multicenter Study
. 2015 Aug;96(8):1435-1441.e1.
doi: 10.1016/j.apmr.2015.02.029. Epub 2015 Mar 18.

Factors associated with pressure ulcers in individuals with spina bifida

Sunkyung Kim  1 , Elisabeth Ward  2 , Brad E Dicianno  3 , Gerald H Clayton  4 , Kathleen J Sawin  5 , Patricia Beierwaltes  6 , Judy Thibadeau  7 ; National Spina Bifida Patient Registry
Collaborators, Affiliations
Multicenter Study

Factors associated with pressure ulcers in individuals with spina bifida

Sunkyung Kim et al. Arch Phys Med Rehabil. 2015 Aug.

Abstract

Objective: To describe factors associated with pressure ulcers in individuals with spina bifida (SB) enrolled in the National Spina Bifida Patient Registry (NSBPR).

Design: Unbalanced longitudinal multicenter cohort study.

Setting: Nineteen SB clinics.

Participants: Individuals with SB (N=3153) enrolled in 19 clinic sites that participate in the NSBPR.

Interventions: Not applicable.

Main outcome measures: Pressure ulcer status (yes/no) at the annual visit between 2009 and 2012.

Results: Of 3153 total participants, 19% (n=603) reported ulcers at their most recent annual clinic visit. Seven factors-level of lesion, wheelchair use, urinary incontinence, shunt presence, above the knee orthopedic surgery, recent surgery, and male sex-were significantly associated with the presence of pressure ulcers. Of these factors, level of lesion, urinary incontinence, recent surgery, and male sex were included in the final logistic regression model. The 3 adjusting variables-SB type, SB clinic, and age group-were significant in all analyses (all P<.001).

Conclusions: By adjusting for SB type, SB clinic, and age group, we found that 7 factors-level of lesion, wheelchair use, urinary incontinence, shunt presence, above the knee orthopedic surgery, recent surgery, and male sex-were associated with pressure ulcers. Identifying key factors associated with the onset of pressure ulcers can be incorporated into clinical practice in ways that prevent and enhance treatment of pressure ulcers in the population with SB.

Keywords: Pressure ulcer; Rehabilitation; Risk factors; Spinal cord injuries.

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Figures

Fig 1
Fig 1
Count (#) of pressure ulcers by location for myelomeningocele (top) and others (bottom) at the most recent annual clinic visit.
Fig 2
Fig 2
Adjusted prevalence (%) of pressure ulcers by associated factors over various age groups for myelomeningocele (top) and others (bottom), adjusting SB clinic. Adjusted prevalence was calculated using GEE analysis. Each model included the factor of interest, age group, SB type, and SB clinic.
Fig 3
Fig 3
OR (95% CI) for SB clinics in the final model.
See this image and copyright information in PMC

References

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