Pressure ulcer risk factors in persons with spinal cord injury part 2: the chronic stage.
BACKGROUND
Pressure ulcers (PUs) are a common complication following spinal cord injury (SCI). Prevalence for persons in the chronic SCI stage varies between 15 and 30%. The risk assessment scales used nowadays were designed on pathophysiological concepts and are not SCI-specific. Recently, an epidemiological approach to PU risk factors has been proposed for designing an SCI-specific assessment tool. The first results seem quite disappointing, probably because of the level of evidence of the risk factors used.


OBJECTIVE
To determine PU risk factors correlated to the chronic stage of SCI.


METHODS
Systematic review of the literature.


RESULTS
There are several PU risk factors for chronic SCI stage: socio-demographics, neurological, medical or behavioral. The level of evidence varies: it is quite high for the socio-demographics and neurological factors and low for behavioral factors.


CONCLUSIONS
Behavioral risk factors (relieving the pressure, careful skin monitoring, smoking) are probably the ones for which a preventive strategy can be established. It is important to develop specific assessment tools for these behavioral risk factors to determine their relevance and evaluate the effect of therapeutic educational programs on persons with SCI.
Département de Médecine Physique et de Réadaptation, Centre Hospitalo-Universitaire Caremeau, Nîmes, France. Anthony_gelis@yahoo.fr
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Gélis
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Dupeyron
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Legros
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Benaïm
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Pelissier
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Fattal
D000367:Age Factors; D004185:Disability Evaluation; D005260:Female; D015438:Health Behavior; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D003668:Pressure Ulcer / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D012196:Review Literature as Topic; D012307:Risk Factors; D012737:Sex Factors; D013119:Spinal Cord Injuries / Q000150:complications* / Q000453:epidemiology