Spinal cord injury (SCI) is a serious, irreversible condition that is commonly associated with long-term disability, including partial or total paralysis. Because many SCI patients are bedbound as a result of their injuries, they are prone to developing pressure injuries (also called pressure sores or bedsores), a localized area of damaged skin and soft tissue caused by prolonged pressure and immobility. In the United States, about 30% of SCI patients will develop a pressure injury within five years of their injury, and about 85% will develop a pressure injury at some point in their lifetime. In addition to significant impacts on quality of life, pressure injuries increase risk of morbidity and mortality among SCI patients. Yet despite ample evidence that pressure injuries are a common and debilitating condition among people with SCI, little research has examined global factors that increase an individual’s risk of developing these injuries.
To address this knowledge gap, a team of researchers in China conducted a systematic review of international studies about the incidence of pressure injuries among SCI patients. The team assessed 1,652 studies for their scientific rigor and relevance, eventually narrowing their review to 29 high-quality studies comprising data from 82,722 SCI patients in total. After compiling and analyzing the results of each study, the research team found that:
- Total global incidence of pressure injuries among SCI patients was 23%, but this figure varied significantly by country. Incidence was much higher in South American countries (43% incidence) and African countries (36%), compared to European countries (25%), North American countries (23%), and Asian countries (16%).
- Incidence of pressure injuries tended to decline over time, especially after 2000.
- SCI patients who received treatment in community settings (such as long-term care facilities, or at home) were more likely to develop pressure injuries than those who were treated in the hospital.
These results indicate that the incidence of pressure injuries have declined as a result of recent interventions to prevent or treat these injuries among immobile patients. However, people with SCI living in developing countries remain at significantly higher risk for developing pressure injuries. Resource scarcity in these countries limits patients’ access to sufficient treatment for pressure injuries, reflecting a need to improve global distribution of medical resources to ensure that all SCI patients receive high-quality care.
Chen HL, Cai JY, Shen HW, et al. Incidence of pressure injury in individuals with spinal cord injury. Wound Ostomy and Continence Nursing. (May 2020).