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AJPM&R Journal Club Podcast: Factors Associated with Pressure Ulcer Risk in Spinal Cord Injury Rehabilitation
Gerben DeJong
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This Journal Club Podcast is brought to you by Association of Academic Physiatrists and features research published in the American Journal of Physical Medicine & Rehabilitation.

Dr. Sunil Sabharwal interviews Dr. Gerben DeJong, author of the article entitled "Factors Associated with Pressure Ulcer in Spinal Cord Injury Rehabilitation".

The aim of this study was to identify patient and clinical factors most strongly associated with a spinal cord injury patient's risk for developing a pressure ulcer (PU) during rehabilitation.

This is a prospective observational cohort study conducted at an urban rehabilitation hospital-based specialized spinal cord injury center. The main outcome measure was the onset of a stage 2 or higher PU.

Study patients (N = 159) with new (n = 66) and patients with earlier (n = 99) spinal injuries had identical rates at which they acquired a new PU (stage >=2) in rehabilitation-13.1%. The patients who came to rehabilitation with a PU or myocutaneous flap exhibited a higher rate of developing yet another PU while in rehabilitation (30.2%) than those who came to rehabilitation without an existing PU or flap (6.9%). Logistic regression analysis identified two variables that best predicted a patient's risk at admission for developing a PU during rehabilitation (c = 0.77)-entering rehabilitation with a PU and admission Functional Independence Measure transfers score of less than 3.5.

The greatest risk of developing a new PU in rehabilitation is being admitted with an existing PU followed by admission Functional Independence Measure transfers score of less than 3.5. Using these two variables, one can develop a patient PU risk algorithm at admission that can alert clinicians for the need to enhance vigilance, skin monitoring, and early patient education.

Gerben DeJong, PhD, FACRM is a senior fellow and director of the Center for Post-acute Innovation and Research at the MedStar National Rehabilitation Network (MedStar NRH) in Washington, DC. Prior to rejoining MedStar NRH in late 2004, Dr. DeJong served a two-year stint with the University of Florida as a Research Professor in the Department of Health Services Research, Management and Policy. Until 2001, Dr. DeJong served for 16 years (1985-2001) as the Director of Research for the MedStar National Rehabilitation Network in Washington, DC, and as the founding director of the network's Center for Health & Disability Research. Dr. DeJong has conducted several large multi-center health outcome studies. He is the author or co-author of more than 250 papers on health policy, income maintenance, disability, post-acute rehabilitation, and health outcomes. He has been an avid student of the American post-acute health care system particularly its growth, development, and consolidation across the various post-acute industries. Dr. DeJong served as President of the American Congress of Rehabilitation Medicine in 2006-07. In 1985, he received the Licht Award for Excellence in Scientific Writing from the American Congress of Rehabilitation Medicine and, in 1998, he received the organization's highest award, the Gold Key Award.

Availability: On-Demand
Cost: FREE
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