Risk Factors for Pressure Injury Development in Patients With Spinal Cord Injury Beyond Index Hospitalization: An Analysis of Violent Mechanism of Injury and Socioeconomic Disparity

Abstract

Introduction. PIs are very common in those with SCI and pose a significant health and economic burden. Optimal prevention strategies require rapid identification of high-risk populations. Objective. The authors examined risk factors for PI in persons with traumatic SCI, focusing on mechanism of injury and sociodemographic variables. Materials and Methods. Patients aged 18 years or older at the authors’ institution who had a traumatic SCI between January 1, 2002, and December 31, 2018 were included. Descriptive statistics and logistic regression analyses were conducted. Results. Of 448 patients, 94 patients (21%) had a violent SCI and 163 patients (36%) developed PIs. Violent mechanism of SCI was a significant predictor of a single (56% vs 31%; P <.001) or multiple PIs (83% vs 61%; P <.01), flap coverage (26% vs 17%; P <.05), and higher median stage PI (stage 4 vs stage 3, P <.05). Male sex (OR = 2.08; P <.05), complete SCI (OR = 5.51; P <.001), and violent mechanism of SCI (OR = 2.36; P <.01) were significant predictors on multivariate analysis. Increasing age at the time of SCI (OR = 1.01; P <.05) and unmarried marital status (OR = 1.77; P <.01) were predictive on univariate analysis. Conclusions. Patients of male sex, complete SCI, and violent mechanism of SCI may be at higher risk of PI development and would benefit from more intensive prevention initiatives.