|Onigbinde et al. 2012
|Population: Mean age: 42.7 yr; Gender: males=204, females=114; Injury etiology: SCI=159, orthopaedic=123, head injury=36.
Data Collection: A structured questionnaire was used by hospital staff to gather information on socio-demographic and health data including age, diagnosis, date of admission, the date of skin breakdown (if any) and site of any ulcer.
|1. Mean age of participants was 42.7±15.1 yr.
2. 44 inpatients developed nosocomial pressure injuries within the three mo study period.
3. The mean age of those who developed pressure injuries was 41.18±13.98 yr. The incidence rate was 13.84%.
4. Among those who developed pressure injuries, 22 (50%) had spinal cord injuries. Therefore, of 48 people with a SCI, 45.8% developed a pressure injury.
5. Of the 44 inpatients with pressure injuries, 32 (72.7%) were men and 12 (27.3%) women.
6. The period between time of admission and first appearance of pressure injury ranged from 3-90 days, with a median of 25 days.
7. At onset, only four (9.1%) ulcers were classified as stage 2 ulcers, after 90
days, 23 (52.3%) ulcers were at stage 2.
8. Of the 44 patients who developed pressure injuries, 38 developed them at the sacrum, 20 on the heels and two at the occiput.
|Taghipoor et al. 2009
|Population: Median age ranges: 21-30 and 30-40 yr; Gender: males=71.8%, females=28.2%; Injury etiology: traumatic=63.2%, non-traumatic=35.2%.
Data Collection: Patients who received financial, medico-social, and rehabilitative support provided by the State Welfare Organization of Iran.
|1. Overall incidence of pressure injury was 39.2% (71.8% traumatic, 28.2% nontraumatic)
2. Age was a factor associated with pressure injury in patients with nontraumatic SCI, but not level of injury, education, and occupational status.
3. Only occupation and education were factors associated with pressure injury in traumatic SCI (p<0.01), but not age.
|Nogueria et al. 2006
|Population: Age ranges: <20 yr=8, 21- 30=17, 31-40=5, 41-50 yr=7, 51-60=3, >60=3; Gender: males=45, females=2; Level of injury: C=19, T=21, L=7.
Data Collection: Database on patients who received care at Ribeirão Preto Medical School Hospital das Clínicas.
|1. Overall incidence of pressure injury was 42.5% (mean=2.3 pressure injury per patient).
2. Incidence by number pressure injury: 0=27 (57.4%), 1=7 (15.0%), 2=5 (10.6%), 3=4 (8.5%), 4=3 (6.4%), 5=1 (2.1%).
3. Incidence of pressure injury by grade: Grade 1=10.9%, Grade 2=17.4%, Grade 3=6.5%, Grade 4=13.0%, Unknown=52.2%.
4. Most common regions of pressure injury: sacrum=36.9%, heel=17.4%, gluteal=10.8%), ischium=10.8%), coccyx=6.5%.
|Raghaven et al. 2003
|Population: Mean age: 47±14.7 yr; Gender: males=76.0%, females=24.0%; Mean time since SCI: 13.0±10.6 yr; Etiology of injury: traumatic SCI=425, spina bifida=2.
Data Collection: Postal survey assessing pressure injury among individuals with SCI in the community who were being followed
by the medical centre.
|1. Point prevalence was 23%.
2. *Incidence of Grade 1=12.4%, Grade 2=10.3%, and Grade 1 and 2=0.5%.
3. Most common pressure injury sites: heel=10.8%, sacrum=14%, and
4. 55% had a Grade 2+ pressure injury at any point since their SCI.
5. Current smoking and regular inspection of skin was associated with the
occurrence of pressure injury.
*N=45 patients not included in these results.
|Walters et al. 2002
|Population: Most patients were >50 yr and had their SCI >10 yr ago.
Data Collection: A database was created to track patients’ self-reported long-term SCI complications following rehabilitation.
|1. Overall prevalence was 38%.
2. Pressure injury occurred primarily in sacral, ischial, and trochanteric areas (71%).
|Klotz et al. 2002
|Population: Mean age: 43.6 yr, Gender: males=80%, females=20%; Level of injury: C1-C2=10.5%, C3=13.1%, C4=15.4%, C5=13.9%, C6=13.4%, C7-C8=10.4%; Mean time since injury: 12.9 yr
Data Collection: Tetrafigap survey – a self-reported questionnaire given to individuals in rehabilitation.
|1. 19.7% of re-hospitalization cases were due to pressure injuries.
|Chen et al. 1999
|Population: Mean age: 36.5 yr, Gender: males=79%, females=21%; Level of injury: incomplete tetraplegia (31%), complete paraplegia (29%), complete tetraplegia (20%), and incomplete paraplegia (19%); Time since SCI: 3 yr=702, 2 yr=716, 1 yr=231.
Data Collection: Information was collected from the National SCI Statistical Center
|1. Incidence of pressure injury by grade: Grade 1=27.3%, Grade 2=54.5%, Grade 3=11.9%, Grade 4=3.2%, Unknown=2.8%.
2. Participants in rehabilitation; 63.9 had one ulcer, 21.2% had two ulcers, 10.5% had three ulcers, and 4.3% had four or more ulcers.
3. Pressure injuries were found most in the sacrum (39%), heels (13%) and ischium (8%).
4. Higher percentage of pressure injuries for participants with complete injuries; 23.1% of complete paraplegia, and 39.5% of complete tetraplegia had at least one ulcer.
|Mckinely et al. 1999
|Population: Time since injury: 1 yr=6,776, 2 yr=5,744, 5 yr=4,100, 10 yr=2,399, 15 yr=1,285, 20 yr=500.
Data Collection: Information was collected from the National SCI Statistical Center (NSCISC) database of all patients admitted from 1973 and had a follow-up phone evaluation in 1986-1998.
|Prevalence of pressure injury by time since SCI:
1. 1 yr (n=4,978), 2 yr (n=3,421), 5 yr (n=2,079), 10 yr (n=1,073), 15 yr (n=450), 20 yr (n=102). Prevalence of pressure injury by time since SCI and level of injury:
2. Incomplete Paraplegia – 1 yr=5.6%, 2 yr=8.3%, 5 yr=10.9%, 10 yr=14.5%, 15 yr=18.4%, 20 yr=12.5%.
3. Complete Paraplegia – 1 yr=22.3%, 2 yr=24.5%, 5 yr=25.5%, 10 yr=28.2%, 15 yr=26.7%, 20 yr=29.8%.
4. Incomplete Tetraplegia – 1 yr=9.3%, 2 yr=10.2%, 5 yr=11.5%, 10 yr=18.4%, 15 yr=20.8%, 20 yr=13.3%.
5. Complete Tetraplegia – 1 yr=25.2%, 2 yr=26.4%, 5 yr=27.2%, 10 yr=25.1%, 15 yr=27.6), 20 yr=40.6%.
6. Individuals who sustained SCI from acts of violence were the most common etiology for pressure injuries.
7. Individuals with paraplegia had the highest prevalence of grade 3 and 4 ulcers (9.1%)
|Anson & Shepherd 1996
|Population: Mean age: 37 yr; Gender: males=81.9%, females=18.1%; Level of injury: C0-C4=67, C5-C8=123; T1- T11=100, T12-S5=50; Time since SCI: 1-2 yr=90, 3-5 yr=88, 6-10 yr=10, 11-15 yr=41, >15 yr=27.
Data Collection: Information was collected when patients returned to outpatient clinics for routine follow-up examinations.
|Incidence of all grades of pressure injury by time since SCI:
Grade 1 or 2=83.3%, Grade 3 or 4=16.6%.
Incidence of Grade 1 or 2 pressure injury by time since SCI:
1. 1-2 yr=92.3%; 3-5 yr=82.4%, 6-10 yr=96.5%, 11-15 yr=94%, >15 yr=68.4%.
Incidence of Grade 3 or 4 pressure injury by time since SCI:
2. 1-2 yr=7.7%, 3-5 yr=17.6%, 6-10 yr=13.5%,11-15 yr=16%, >15 yr=31.6%.
3. The most common locations were foot/heel (27%), sacrum (18.3%), and ischium (18.2%).
4. The most common identified etiology for pressure injuries were lack of weight shifts, postural problems, hot water burns, and improper turning in bed.