The relationship of pressure ulcers, race, and socioeconomic conditions after spinal cord injury.
OBJECTIVE
To identify risks factors associated with pressure ulcers (PrU) after spinal cord injury (SCI) by examining race and indicators of socioeconomic status (measured by income and education). We hypothesize African Americans will have a greater risk for PrUs than whites, but this relationship will be mediated by the 2 socioeconomic status indicators.


METHODS
Cohort study.


METHODS
A large rehabilitation hospital in the southeastern US.


METHODS
1466 white and African American adults at least 1-year post-traumatic SCI.


METHODS
(a) PrUs in the past year, (b) current PrU, (c) surgery to repair a PrU since injury.


RESULTS
In preliminary analyses, race was significantly associated with having a current PrU and with having surgery to repair a PrU since injury. In multivariable analyses, the relationships of PrU with having a current PrU and with having surgery to repair a PrU were both mediated by income and education such that the relationships were no longer significant. Lower income was associated with increased odds of each PrU outcome. After controlling for other variables in the model, education was associated with increased odds of having a current PrU.


CONCLUSIONS
These findings help clarify the relationships between race and socioeconomic status with PrUs after SCI. Specifically, a lack of resources, both financial and educational, is associated with worse PrU outcomes. These results can be used by both providers and policy makers when considering prevention and intervention strategies for PrUs among people with SCI.
Department of Health Sciences and Research, Medical University of South Carolina, Charleston, South Carolina 29425, USA. saundel@musc.edu
Lee L
LL
Saunders
James S
JS
Krause
Bridget A
BA
Peters
Karla S
KS
Reed
D000328:Adult; D000368:Aged; D044383:Black People / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D003668:Pressure Ulcer / Q000191:economics / Q000453:epidemiology / Q000209:etiology; D012307:Risk Factors; D012959:Socioeconomic Factors; D015144:Southeastern United States / Q000453:epidemiology; D013119:Spinal Cord Injuries / Q000150:complications / Q000191:economics / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult; D001741:Black or African American