title: Does the Acute Care Spinal Cord Injury Setting Predict the Occurrence of Pressure Ulcers at Arrival to Intensive Rehabilitation Centers?
abstract: OBJECTIVE
  The objective of this study was to evaluate the impact of acute care in specialized spinal cord injury (SCI) trauma centers on the prevalence of pressure ulcers (PU) upon arrival at a functional rehabilitation center after a traumatic SCI.
  
  
  METHODS
  This is a retrospective cohort study among 123 patients with traumatic SCI referred to intensive functional rehabilitation between January 1, 2009, and December 31, 2011. Group 1 (n = 90) was referred from a level 1 specialized SCI trauma center and group 2 (n = 33) was referred from seven trauma centers not specialized in SCI.
  
  
  RESULTS
  The total prevalence of patients with PU at admission to functional rehabilitation was 33.3% (26.7% in group 1 and 51.5% in group 2, P = 0.017). There were also more patients with multiple PU in group 2 (24.2% vs. 2.2%, P = 0.0001). A binary logistic regression showed a significant relationship between the occurrence of PU and the type of acute care facility as well as the ASIA (American Spinal Injury Association) Impairment Scale grade. Receiving acute care at the specialized SCI trauma center was associated with a decrease in the number of patients developing one and multiple PU.
  
  
  CONCLUSIONS
  These results highlight the importance of specialized SCI trauma centers in acute care of patients with traumatic SCI in reducing PU at their admission to functional rehabilitation settings.
authors.affiliation: From the Hôpital du Sacré-Coeur, Montréal, Canada (AR-D, CT, SP, J-MM-T); Faculty of Medicine, University of Montreal, Montreal, Canada (AR-D, ÉB-M, SP, J-MM-T); Hôpital Sainte-Justine, Montreal, Canada (SP, J-MM-T); and Institut de Réadaptation Gingras-Lindsay de Montreal, Montreal, Canada (AR-D).
authors.forename: Andréane
authors.initials: A
authors.lastname: Richard-Denis
authors.forename: Cynthia
authors.initials: C
authors.lastname: Thompson
authors.forename: Étienne
authors.initials: É
authors.lastname: Bourassa-Moreau
authors.forename: Stefan
authors.initials: S
authors.lastname: Parent
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Mac-Thiong
mesh_terms: D015998:Abbreviated Injury Scale; D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D003668:Pressure Ulcer / Q000453:epidemiology*; D015995:Prevalence; D011792:Quebec / Q000453:epidemiology; D012017:Referral and Consultation; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000453:epidemiology / Q000534:rehabilitation* / Q000601:surgery; D014193:Trauma Centers