Factors Associated with Pressure Ulcers in Individuals with Spina Bifida

Sunkyung Kim, Elisabeth Ward, Brad E. Dicianno, Gerald H. Clayton, Kathleen J. Sawin, Patricia Beierwaltes, Judy Thibadeau, William Walker, Kathryn Smith, Kurt Freeman, Pamela Wilson, Kathleen Sawin, Jeffrey Thomson, Heidi Castillo, Timothy Brei, David Joseph, Elaine Pico, Mitul Kapadia, Robin Bowman, John Wiener & 5 others Paula Peterson, Mark Dias, Karen Ratliff-Schaub, Brad Dicianno, James Chinarian

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1435-1441.e1
JournalArchives of Physical Medicine and Rehabilitation
Volume96
Issue number8
DOIs
StatePublished - Aug 1 2015

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Spinal Dysraphism
Pressure Ulcer
Urinary Incontinence
Wheelchairs
Orthopedics
Registries
Knee
Age Groups
Logistic Models
Ambulatory Care
Multicenter Studies
Ulcer
Cohort Studies
Outcome Assessment (Health Care)

All Science Journal Classification (ASJC) codes

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

Cite this

Kim, S., Ward, E., Dicianno, B. E., Clayton, G. H., Sawin, K. J., Beierwaltes, P., ... Chinarian, J. (2015). Factors Associated with Pressure Ulcers in Individuals with Spina Bifida. Archives of Physical Medicine and Rehabilitation, 96(8), 1435-1441.e1. https://doi.org/10.1016/j.apmr.2015.02.029
Kim, Sunkyung ; Ward, Elisabeth ; Dicianno, Brad E. ; Clayton, Gerald H. ; Sawin, Kathleen J. ; Beierwaltes, Patricia ; Thibadeau, Judy ; Walker, William ; Smith, Kathryn ; Freeman, Kurt ; Wilson, Pamela ; Sawin, Kathleen ; Thomson, Jeffrey ; Castillo, Heidi ; Brei, Timothy ; Joseph, David ; Pico, Elaine ; Kapadia, Mitul ; Bowman, Robin ; Wiener, John ; Peterson, Paula ; Dias, Mark ; Ratliff-Schaub, Karen ; Dicianno, Brad ; Chinarian, James. / Factors Associated with Pressure Ulcers in Individuals with Spina Bifida. In: Archives of Physical Medicine and Rehabilitation. 2015 ; Vol. 96, No. 8. pp. 1435-1441.e1.
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abstract = "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.",
author = "Sunkyung Kim and Elisabeth Ward and Dicianno, {Brad E.} and Clayton, {Gerald H.} and Sawin, {Kathleen J.} and Patricia Beierwaltes and Judy Thibadeau and William Walker and Kathryn Smith and Kurt Freeman and Pamela Wilson and Kathleen Sawin and Jeffrey Thomson and Heidi Castillo and Timothy Brei and David Joseph and Elaine Pico and Mitul Kapadia and Robin Bowman and John Wiener and Paula Peterson and Mark Dias and Karen Ratliff-Schaub and Brad Dicianno and James Chinarian",
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Kim, S, Ward, E, Dicianno, BE, Clayton, GH, Sawin, KJ, Beierwaltes, P, Thibadeau, J, 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 2015, 'Factors Associated with Pressure Ulcers in Individuals with Spina Bifida', Archives of Physical Medicine and Rehabilitation, vol. 96, no. 8, pp. 1435-1441.e1. https://doi.org/10.1016/j.apmr.2015.02.029

Factors Associated with Pressure Ulcers in Individuals with Spina Bifida. / Kim, Sunkyung; Ward, Elisabeth; Dicianno, Brad E.; Clayton, Gerald H.; Sawin, Kathleen J.; Beierwaltes, Patricia; Thibadeau, Judy; Walker, William; Smith, Kathryn; Freeman, Kurt; Wilson, Pamela; Sawin, Kathleen; Thomson, Jeffrey; Castillo, Heidi; Brei, Timothy; Joseph, David; Pico, Elaine; Kapadia, Mitul; Bowman, Robin; Wiener, John; Peterson, Paula; Dias, Mark; Ratliff-Schaub, Karen; Dicianno, Brad; Chinarian, James.

In: Archives of Physical Medicine and Rehabilitation, Vol. 96, No. 8, 01.08.2015, p. 1435-1441.e1.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Factors Associated with Pressure Ulcers in Individuals with Spina Bifida

AU - Kim, Sunkyung

AU - Ward, Elisabeth

AU - Dicianno, Brad E.

AU - Clayton, Gerald H.

AU - Sawin, Kathleen J.

AU - Beierwaltes, Patricia

AU - Thibadeau, Judy

AU - Walker, William

AU - Smith, Kathryn

AU - Freeman, Kurt

AU - Wilson, Pamela

AU - Sawin, Kathleen

AU - Thomson, Jeffrey

AU - Castillo, Heidi

AU - Brei, Timothy

AU - Joseph, David

AU - Pico, Elaine

AU - Kapadia, Mitul

AU - Bowman, Robin

AU - Wiener, John

AU - Peterson, Paula

AU - Dias, Mark

AU - Ratliff-Schaub, Karen

AU - Dicianno, Brad

AU - Chinarian, James

PY - 2015/8/1

Y1 - 2015/8/1

N2 - 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.

AB - 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.

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