Laboratory Signs of Enteric Failure - Predictors of Pressure Ulcers in Traumatic Spinal Cord Disease

Abstract

Relevance. Among the complications of traumatic spinal cord disease (SCD) pressure ulcers occupy a special place, with incidence reaching 68% and showing no tendency for decreasing. Literature reviews one of the main reasons for the formation of decubital ulcers is enteral insufficiency, the timely detection of which is still a common problem for many medical specialties, and laboratory indicators pointing to its manifestation remain in the zone of a controversial issue. New knowledge regarding laboratory predictors of pressure ulcer formation in the acute period of trauma will reduce the risk of decubital ulcerative defects.Purpose of the study. Based on the analysis of laboratory blood levels in the acute and early periods of hip joint injury, to identify predictors of the formation of pressure ulcers in patients with spinal trauma.Materials and methods. 68 case histories of adult patients with hip injury were retrospectively analyzed. The victims were treated in the City Clinical Hospital No. 39 of the Kanavinsky District of Nizhny Novgorod for the period from 2013 to 2020.Results and discussion. A comparative analysis of blood levels on the first day after injury showed that patients with subsequently developed bedsores at the early stages of treatment got hypoproteinemia and a decrease in serum creatinine levels more often than patients without bedsores. In addition, white blood cell count in patients with pressure ulcers was elevated, compared to normal values and patients without pressure ulcers white blood cell count. For a year creatinine and total protein values in patients of the main group tended to be or completely became normal, which is most likely associated with adequately administered enteral nutrition. The white blood cell count of the study group decreased to the normal range.Conclusion. Increased white blood cell, a decrease creatinine levels and total protein values in patients with HSC in the first hours after injury confirms the catabolic orientation of metabolism in the acute period of spinal cord injury, so it leads to conclusion that the early intensive therapy aimed at arresting protein losses and inflammation is needed, which in turn will prevent the formation of pressure ulcers in the early period of traumatic spinal cord disease.