Pressure Ulcer in Trauma Patients: A Higher Spinal Cord Injury Level Leads to Higher Risk

Area of Science:

• Trauma Surgery
• Neurosurgery
• Wound Care

Background:

• Previous systematic reviews indicated no association between spinal cord injury (SCI) level and pressure ulcer (PU) risk.
• This study hypothesized that upper-SCI (cervical/thoracic) presents a higher PU risk than lower-SCI (lumbar/sacral) in acute trauma.

Purpose of the Study:

• To investigate the association between SCI level and PU development in acute trauma patients.
• To identify risk factors for PUs in trauma patients with SCI.

Main Methods:

• Retrospective analysis of the National Trauma Data Bank (NTDB) from 2007-2015.
• Multivariable logistic regression analysis was employed to determine PU risk factors.

Main Results:

• Of 62,929 patients with SCI (0.9%), 5.1% developed PUs.
• Patients with upper-SCI had a significantly higher incidence of PUs (5.8%) compared to lower-SCI (2.2%).
• SCI was the strongest predictor for PU (OR=13.77), with upper-SCI showing a 2.81-fold greater risk than lower-SCI.

Conclusions:

• A higher SCI level is associated with a three-fold greater risk for PU development compared to lower SCI levels.
• Findings contradict previous reports, emphasizing the importance of SCI level in PU risk stratification for trauma patients.