Susceptibility of pressure ulcer development of patients with SCI in accordance with lifestyle at COMMUNITY IN BANGLADESH

Abstract

Background: With spinal cord injury there are chances of having secondary complication and pressure ulcer is one of them, which is causing morbidity and increase in mortality among the patients especially in the community patients living with spinal cord injury. Objectives: To study the associations between selected daily living lifestyles factors and pressure ulcer development in adults with spinal cord injury (SCI). Methods: 1:1 case-control study was carried out among to accomplish the objective of this study. A total 80 participants, 40 cases with pressure ulcer and 40 controls with no pressure ulcer were taken as sample. The well-structure questionnaire was used to identify the possible lifestyle factors with risk in pressure ulcer development. Data was analyzed by using SPSS and various tests such as frequency distribution, chi-square (χ2) and odds ratio. Odd ratio was calculated as a model of association between exposure and outcomes. Results: Factors that significantly increased the risk of having pressure ulcer were being male (OR=3.12; 95% of CI=1.18- 8.2) and incontinence of bladder (OR=2.5, 95% of CI=1.016-61.49). Factors that significantly protected against pressure ulcer were avoiding smoking (OR=0.74, 95% of CI= 0.065-0.464), doing exercises to keep joint flexible (OR= 0.086; 95% of CI= 0.028-0.267), doing strengthening exercise (OR=0.07, CI=0.22-0.25), doing leg activities which help to increase bone density (OR=0.37, 95%o f CI=0.26-0.51), visiting therapist to monitor exercise (OR=0.098, 95 % of CI= 0.02-0.447), pay attention to position body in wheelchair (OR= 0.365, 95% of CI= 0.264-0.506), pay attention to position body while sleeping (OR=0.01, 95% of CI= 0.02-0.45), know what do when contracture begin (OR= 0.15, 95% of CI= 0.06-0.41), checking skin regularly (OR= 0.365, 95% of CI= 0.26-0.51), perform pressure relief every 30 min (OR= 0.073, 95% of CI= 0.019-0.277), careful while transfer (OR= 0.038, 95% of CI= 0.05-0.309), wear something on foot when out of bed (OR= 0.043, 95% of CI= 0.009-0.203), aware of wheelchair cushion (OR= 0.06, 95% of CI= 0.007-0.487), accessible house (OR= 0.091, 95% of CI= 0.0270.304), using intermittent catheter (OR= 0.328, 95% of CI= 0.111-0.969), using catheter as directed (OR= 0.265, 95% of CI= 0.085-0.83) and using rectal suppository for bowel management (OR=0,11, 95% of CI 0.029–0.416).Conclusion: This study showed highest risk among being male and patient with incontinence of bladder as significant risk in pressure ulcer development.