Pressure ulcer risk in spinal cord injury: Predictors of ulcer status over3 years

Objective: To identify predictors of pressure ulcers in men with spinal cor d injury over a 3-year period. Design: Longitudinal, two-panel, cohort. Setting: Community. Participants: One hundred eighteen men with spinal cord injury. Measures: Interviews, questionnaires, and physical examinations were comple ted in two phases, 3 years apart. Information obtained included demographic and spinal cord injury characteristics; ulcer history; health beliefs and practices; measures of impairment, disability, and handicap; and skin integ rity. Results: Thirty-one percent of the participants reported having a pressure ulcer in the 12 months before Phase 2. Some Phase 1 predictors of self-repo rted ulcers in the year before Phase 2 were a younger age at onset of spina l cord injury, previous pressure ulcer surgery, and the presence of a press ure ulcer in the year before Phase 1. On examination at Phase 2, 59% presen ted with an ulcer. Phase 1 predictors of ulcer presence at Phase 2 examinat ion were similar to predictors for self-reported ulcers. Conclusion: Individuals with the identified predictive characteristics are at greater risk for developing pressure ulcers. These individuals should re ceive additional interventions to reduce that risk. Potential interventions include more systematic and frequent follow-up, frequent review of pressur e ulcer prevention and management strategies, and provision of needed perso nal assistance and relevant equipment.