title: Risk factors for pressure ulceration in a resource constrained spinal injury service.
abstract: METHODS
  Pressure ulceration and other complications constitute an encumbrance in the management of spinal cord injury in many services with limited resources in developing countries. These services undertake patients' care without adequate prehospital care, limited modern infrastructure and limited number of trained staff.
  
  
  OBJECTIVE
  To evaluate the associated risk factors for pressure ulceration in traumatic spinal cord injured managed in a resource constrained spinal injury unit in Lagos, Nigeria. A regional acute trauma and rehabilitation centre serving a population of >20 million.
  
  
  METHODS
  This is a prospective study in patients presenting with traumatic spinal cord injury between 1 October 2004 and 30 November 2006. The data collected include demographic characteristics, interval before admission in the unit, type of spinal cord injury and serum albumin. The incidence of pressure ulcers and the isolated organisms was recorded for patients who developed pressure ulcers on admission and during the period of stay in the unit. The length of hospital stay was also recorded for all the patients.
  
  
  RESULTS
  The overall incidence of pressure ulceration on admission was 57.1%. There was an average lengthening of hospital stay of 33.1 days in the group of patients with pressure ulceration compared to patients without pressure ulcers. The nutritional status on admission, interval before admission and the type of neurological injury were significant factors for the incidence of pressure ulcers.
  
  
  CONCLUSIONS
  The incidence of pressure ulceration was high, delay in admission and poor nutritional status may be significant factors in the incidence of pressure ulceration in spinal cord injury.
authors.affiliation: Department of Orthopaedics and Trauma Surgery, National Orthopaedic Hospital, Igbobi, Yaba Lagos, Nigeria. ashikoashiko@yahoo.com
authors.forename: O K
authors.initials: OK
authors.lastname: Idowu
authors.forename: W
authors.initials: W
authors.lastname: Yinusa
authors.forename: S A
authors.initials: SA
authors.lastname: Gbadegesin
authors.forename: G T
authors.initials: GT
authors.lastname: Adebule
mesh_terms: D000293:Adolescent; D000328:Adult; D015897:Comorbidity / Q000639:trends; D003906:Developing Countries / Q000191:economics; D004632:Emergency Medical Services / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D008875:Middle Aged; D009549:Nigeria / Q000453:epidemiology; D010243:Paralysis / Q000453:epidemiology*; D003668:Pressure Ulcer / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D011446:Prospective Studies; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D013203:Staphylococcal Infections / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D000078329:Workforce; D055815:Young Adult