ArticleJAMA network open2024
Hospital-Acquired Pressure Ulcers and Long-Term Motor Score Recovery in Patients With Acute Cervical Spinal Cord Injury.
Article in JAMA network open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Comparative pharmacotherapeutic efficacy and dose-related safety profiles of intrathecal baclofen: a systematic review and meta-analysis in neurological spasticity.Frontiers in pharmacology · 2026Pooled it
- Effects of early acute in-bed leg cycling initiated from the intensive care unit following severe traumatic spinal cord injury: final results from the PROMPT-SCI trial.Critical care (London, England) · 2026Trial
- Timing of sacral pressure injury development during acute care after traumatic spinal cord injury: a prospective study of 142 patients.Spinal cord · 2026Article
- Functional outcome prediction after traumatic cervical spinal cord injury using ensemble machine learning: a three‑center validation study.Acta neurologica Belgica · 2026Article
- T-cell biomarkers improve urinary tract infection risk stratification beyond clinical characteristics after acute traumatic spinal cord injury.Scientific reports · 2026Observational
- Development and validation of a perioperative risk prediction model for pressure ulcers in neurosurgical procedures: a machine learning approach with protocol compliance metrics.Frontiers in medicine · 2025Article
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Authors and funding
11 authors.
Funding
Abstract
Importance: Pressure ulcers (PUs) are (1) prevalent secondary complications after spinal cord injury (SCI), (2) present with elevated systemic inflammatory tone, and (3) may interfere with healing processes underlying neurological recovery (disrepair). Objective: To investigate whether PUs acquired during initial hospitalization are associated with neurological and functional long-term outcome and survival after SCI. Design, Setting, and Participants: Multicenter cohort study at 20 centers of the prospective SCI Model Systems (SCIMS) Database (Birmingham, AL). Patients with acute traumatic cervical SCI with relevant motor impairment (ie, American Spinal Injury Association [ASIA] impairment scale [AIS] A, B, and C) were enrolled from January 1996 to September 2006 and followed up until June 2016. Data were analyzed from April 2021 to September 2024. Exposures: PUs acquired during surgical or first rehabilitative SCI care. Main outcomes and measures: The change in the ASIA motor score at 1 year after SCI was the primary end point. Secondary end points included the recovery of functional independence measure (FIM) motor score at 1 year after SCI and mortality up to 10 years. ASIA and FIM motor score were analyzed applying linear mixed models with random intercept adjusted for baseline neurological level, AIS, and sociodemographic factors. Mortality was analyzed using Cox regression. Results: The study included 1282 patients with a mean (SD) age of 38.0 (15.7) years and consisted of 1028 (80.2%) male patients. Regarding race and ethnicity, 349 of 1249 (27.9%) were African American patients, 1139 of 1273 (89.5%) were non-Hispanic patients, and 834 of 1249 (66.8%) were White patients. During initial hospitalization, 594 patients (45.7%) acquired PUs. Exposure to PUs was associated with impaired motor recovery 1 year after SCI compared with unexposed patients (-9.1 ASIA motor score points; 95% CI, -12.3 to -6.0; P < .001). In addition, PUs were associated with lower recovery of physical independence 1 year after SCI (-8.3 FIM motor score points; 95% CI: -11.1 to -5.5; P < .001). Cox regression confirmed PUs as a risk marker for death up to 10 years after SCI (hazard ratio, 1.41; 95% CI, 1.09 to 1.82; P = .01). Conclusions and Relevance: In this cohort study, PUs acquired during initial hospitalization after SCI were independently associated with poor long-term neurofunctional outcome. PUs constitute a modifiable factor associated with risk for worse long-term disability (recovery confounder) and elevated mortality.
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