Factors Associated with Pressure Ulcers in Individuals with Spina Bifida

Sunkyung Kim*, Elisabeth Ward, Brad E. Dicianno, Gerald H. Clayton, Kathleen J. Sawin, Patricia Beierwaltes, Judy Thibadeau, William Walker, Kathryn Smith, Kurt Freeman, Pamela Wilson, Kathleen Sawin, Jeffrey Thomson, Heidi Castillo, Timothy Brei, David Joseph, Elaine Pico, Mitul Kapadia, Robin Bowman, John WienerPaula Peterson, Mark Dias, Karen Ratliff-Schaub, Brad Dicianno, James Chinarian

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1435-1441.e1
JournalArchives of physical medicine and rehabilitation
Volume96
Issue number8
DOIs
StatePublished - Aug 1 2015

Keywords

  • Pressure ulcer
  • Rehabilitation
  • Risk factors
  • Spinal cord injuries

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

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