Kim S, Ward E, Dicianno BE, Clayton GH, Sawin KJ, Beierwaltes P, Thibadeau J, National Spina Bifida Patient Registry., et al.
Archives of physical medicine and rehabilitation. Date of publication 2015 Aug 1;volume 96(8):1435-1441.e1.
1. Arch Phys Med Rehabil. 2015 Aug;96(8):1435-1441.e1. doi:
10.1016/j.apmr.2015.02.029. Epub 2015 Mar 18.
Factors associated with pressure ulcers in individuals with spina bifida.
Kim S(1), Ward E(2), Dicianno BE(3), Clayton GH(4), Sawin KJ(5), Beierwaltes
P(6), Thibadeau J(7); National Spina Bifida Patient Registry.
Collaborators: Walker W, Smith K, Freeman K, Wilson P, Sawin K, Thomson J,
Castillo H, Brei T, Joseph D, Pico E, Kapadia M, Bowman R, Wiener J, Peterson P,
Dias M, Ratliff-Schaub K, Dicianno B, Chinarian J.
Author information:
(1)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.
(2)Carter Consulting, Inc., Atlanta, GA.
(3)Department of Physical Medicine and Rehabilitation, University of Pittsburgh
Medical Center, Pittsburgh, PA.
(4)Department of Physical Medicine and Rehabilitation, University of Colorado
Denver and Children's Hospital Colorado, Aurora, CO.
(5)College of Nursing, University of Wisconsin-Milwaukee, Milwaukee, WI;
Children's Hospital of Wisconsin, Milwaukee, WI.
(6)Children's Hospital of Michigan, Detroit, MI; Wayne State University, Detroit,
MI.
(7)Division of Human Development and Disability, National Center on Birth Defects
and Developmental Disabilities, Centers for Disease Control and Prevention,
Atlanta, GA.
OBJECTIVE: To describe factors associated with pressure ulcers in individuals
with spina bifida (SB) enrolled in the National Spina Bifida Patient Registry
(NSBPR).
DESIGN: Unbalanced longitudinal multicenter cohort study.
SETTING: Nineteen SB clinics.
PARTICIPANTS: Individuals with SB (N=3153) enrolled in 19 clinic sites that
participate in the NSBPR.
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: 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.
Copyright © 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.
DOI: 10.1016/j.apmr.2015.02.029
PMCID: PMC4519375
PMID: 25796136 [Indexed for MEDLINE]
