Major risk factors for pressure ulcers in the spinal cord disabled: a literature review

Pressure ulcers remain a dominant health problem for persons with spinal cord injury despite abundant published research describing risk factors. Although information on these factors is plentiful, its usefulness to the spinal cord disabled is limited by three problems. First, the sheer volume is overwhelming; more than 200 risk factors for pressure ulcers have been described in the published literature. For most health care professionals, finding, no less reading and evaluating, the hundreds of articles published on this topic would be difficult. Second, most studies focused on elderly patients in nursing homes. Pressure ulcer risk factors for the spinal cord disabled are often different from those for the elderly; yet many findings from studies of the elderly provide valuable information. Third, inadequate sample sizes often hamper the usefulness of research on the spinal cord disabled. Drawing valid conclusions from these small studies, especially concerning potential risk factors is difficult. To address these three problems, we critically evaluated the medical, nursing, and nutritional research literature that pertained to risk factors for pressure ulcer development. The purpose of this paper is to provide a review of published reports on the principal risk factors for pressure ulcers in persons with spinal cord injuries.