1. Nature and number of complications and risk factors for pressure ulcers after traumatic spinal cord injury: How specialized are we?
Conran Joseph1 , Kerstin Wahman2,3, Lena Nilsson Wikmar1
1Karolinska Institutet, Division of Physiotherapy; 2Karolinska Institutet, Division of Neurodegeneration; 3Rehab Station Stockholm/Spinalis R&D Unit, Stockholm, Sweden
Univariate analysis of pressure ulcer risk factors
Conclusions
Complications, predominantly pressure ulcers and pulmonary complications were prevalent during the acute phase.
The occurrence of pressure ulcers, despite protocols in place, is worrisome. Risk factors found in this study should be screened for in addition to the current assessment scale in use.
Gender (M)
OR: 2.88
P=0.10
Gunshot cause
OR: 4.50
P<0.001
Neuropathic pain
OR: 4.32
P=0.053
Complete SCI
OR: 8.13
P<0.001
Risk factors for pressure ulcers
Spine surgery
OR: 0.52
P=0.08
Vertebral injury
OR: 4.97
P=0.005
LOC
OR: 6.07
P=0.007
Introduction
The development of secondary complications poses a threat to health and wellness after a traumatic spinal cord injury (tSCI). In the acute phase, these complications hinder the rehabilitation process and incur greater health costs.
Results
Pulmonary compl.
OR: 5.02
P<0.001
Complications
Tetraplegic
(n=74)
n (%)
Paraplegic
(n=67)
Total
(N=141)
N (%)
Pulmonary complications
23 (31)
10 (15)
33 (23.4)
Pressure ulcers
19(28)
42 (29.8)
Urinary tract infection
15 (20)
9 (13)
24 (17)
Autonomic dysreflexia
2 (3)
2 (1.4)
Deep vein thrombosis
1 (1)
7(10)
8 (5.7)
Pulmonary embolism
1 (.7)
Postural hypotension
1 (2)
Neuropathic pain
5 (7)
3 (5)
Spasticity
Mean complications per patient
4 (5)
1.0
0.7 
4 (2.8)
UTI
OR: 4:45
P=0.001
*Significant risk factors were considered at P≤ Other non-significant factors not included in the table: age, aetiology, sub-classification of SCI, associated injury, education, pre-injury employment and ethnicity.
Purpose
To determine the nature and number of secondary complications after a tSCI and to identify risk factors for pressure ulcers during acute care.
Acknowledgements
Ethical approval for this study was granted by the Senate Research Committee of the University of the Western Cape. We would like to thank all informants for their participation in the study. Presented at the WCPT Congress 2015, Singapore.
Method
1-year population-based design.
141 participants with acute tSCI were screened for secondary complications during acute care.
Of the sample, 25.5% presented with one complication, 16.6% with two and 8.3% with three or four.
Conran Joseph (PhD candidate)
Department of Neurobiology, Care Sciences and Society
Division of Physiotherapy
Telephone:
Conran’s PhD work focuses on epidemiological aspects, injury characteristics and acute outcomes following traumatic spinal cord injury in South Africa and Sweden.