Lifestyle risk factors for pressure ulcers in community-based patients with spinal cord injuries in Japan

This study aimed to identify daily living-related risk factors for pressure ulcer (PU) occurrence in community-living patients with spinal cord injury (SCI). And also to determine whether seat pressure influences PU occurrence, and how often patients with SCI perform pressure relief activities while living in the community. Kanagawa Rehabilitation Hospital, Kanagawa, Japan.Methods:Thirty-one patients admitted to this hospital for PU treatment were included in the case (PU) group. Thirty outpatients who did not have PUs at the time of the study, and had lived without PUs for at least a year, were included in the control (No PU) group. Patients were interviewed about lifestyle-related PU risk factors and a pressure-mapping system was used to measure interface pressure (IP) on their wheelchair seat. The No PU group patients recorded their daily activities and pressure relief maneuvers for 1 week. Eight lifestyle factors and one risk assessment scale showed significant difference between groups. Three factors exhibited significant odds ratios by logistic regression. IP did not significantly differ between groups. The self-counted number of pressure relief maneuvers (median (25th-75th percentile)) performed per hour in the No PU group was 2.5 (0.7-4.3) and including transfer and urination was 3.5 (2.0-5.3).

Potential PU risk factors associated lifestyle were identified. The scores of one risk assessment scale were also associated with PU risk. The results did not indicate an IP damage threshold. Patients in the No PU group performed pressure relief maneuvers, including related activities, approximately once every 17 min.

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