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Overview :
Byrne and Salzberg identified risk factors associated with
development of pressure ulcers in patients with spinal cord injuries. These can
help identify patients who may require closer monitoring and more aggressive
management. The authors are from the New York Medical College and Castle Point
VA Medical Center in New York.
Spinal cord injury:
(1) decreased level of activity
(2) prolonged immobilization
(3) completeness and level of the spinal cord injury
(4) urine incontinence
(5) fecal incontinence
(6) autonomic dysreflexia/severe spasiticity
Comorbid (pre-existing) illness:
(1) advanced age
(2) pulmonary disease
(3) cardiac disease
(4) diabetes with poor glycemic control
(5) renal disease
(6) impaired cognitive function
(7) circulatory disorders (peripheral vascular disease)
Nutritional and circulatory:
(1) hypoalbuminemia
(2) malnutrition
(3) anemia
(4) extremes of body weight (cachexia, morbid obesity)
(5) edema
Psychological:
(1) noncompliance with pressure ulcer prevention
(2) uncooperative behavior
(3) low self-esteem
Drugs:
(1) sedatives and tranquilizers
(2) steroids and anti-inflammatory agents
Other:
(1) history of a previous pressure ulcer
(2) tobacco use, smoking
(3) friction or shearing of skin surfaces
(4) poverty
(5) poor level of hygiene
(6) residing in a nursing home or hospital
(7) alcohol or drug abuse
Decreased risk:
(1) admission to center specializing in spinal cord
injury
The presence of multiple risk factors identifies a patient
who is at high risk for development of pressure ulceration and who should
receive aggressive preventive care.
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