title: Factors associated with pressure ulcers in individuals with spina bifida.
abstract: OBJECTIVE
  To describe factors associated with pressure ulcers in individuals with spina bifida (SB) enrolled in the National Spina Bifida Patient Registry (NSBPR).
  
  
  METHODS
  Unbalanced longitudinal multicenter cohort study.
  
  
  METHODS
  Nineteen SB clinics.
  
  
  METHODS
  Individuals with SB (N=3153) enrolled in 19 clinic sites that participate in the NSBPR.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Pressure ulcer status (yes/no) at the annual visit between 2009 and 2012.
  
  
  RESULTS
  Of 3153 total participants, 19% (n=603) reported ulcers at their most recent annual clinic visit. Seven factors-level of lesion, wheelchair use, urinary incontinence, shunt presence, above the knee orthopedic surgery, recent surgery, and male sex-were significantly associated with the presence of pressure ulcers. Of these factors, level of lesion, urinary incontinence, recent surgery, and male sex were included in the final logistic regression model. The 3 adjusting variables-SB type, SB clinic, and age group-were significant in all analyses (all P<.001).
  
  
  CONCLUSIONS
  By adjusting for SB type, SB clinic, and age group, we found that 7 factors-level of lesion, wheelchair use, urinary incontinence, shunt presence, above the knee orthopedic surgery, recent surgery, and male sex-were associated with pressure ulcers. Identifying key factors associated with the onset of pressure ulcers can be incorporated into clinical practice in ways that prevent and enhance treatment of pressure ulcers in the population with SB.
authors: Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA. Electronic address: wox0@cdc.gov.
authors: Sunkyung
authors: S
authors: Kim
authors: Carter Consulting, Inc., Atlanta, GA.
authors: Elisabeth
authors: E
authors: Ward
authors: Department of Physical Medicine and Rehabilitation, University of Pittsburgh Medical Center, Pittsburgh, PA.
authors: Brad E
authors: BE
authors: Dicianno
authors: Department of Physical Medicine and Rehabilitation, University of Colorado Denver and Children's Hospital Colorado, Aurora, CO.
authors: Gerald H
authors: GH
authors: Clayton
authors: College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI; Children's Hospital of Wisconsin, Milwaukee, WI.
authors: Kathleen J
authors: KJ
authors: Sawin
authors: Children's Hospital of Michigan, Detroit, MI; Wayne State University, Detroit, MI.
authors: Patricia
authors: P
authors: Beierwaltes
authors: Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA.
authors: Judy
authors: J
authors: Thibadeau
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D003668:Pressure Ulcer / Q000453:epidemiology*; D012737:Sex Factors; D016135:Spinal Dysraphism / Q000145:classification / Q000453:epidemiology*; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data; D015599:Trauma Severity Indices; D014549:Urinary Incontinence / Q000453:epidemiology; D014910:Wheelchairs / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Pressure ulcer; Rehabilitation; Risk factors; Spinal cord injuries