PROGNOSTIC FACTORS IN PATIENTS WITH PRESSURE SORES IN A UNIVERSITY HOSPITAL IN SOUTHERN BRAZIL

ABSTRACT Objective: Despite advances in medical care, patients who are hospitalized or have spinal cord injuries often develop pressure sores. The objective of this study was to describe the epidemiological characteristics of pressure sores and evaluate factors associated with recurrence and cure. Methods: In this historical cohort study, clinical and laboratory data were collected from medical records between 1997 and 2016. Results: Sixty individuals with pressure ulcers were included; mean patient age was 38.1±16.5 (37.0) years, 83.3% were men, and 86.8% identified as white. Most patients (85.1%) had paraplegia, amputation, or trauma of the lower limbs with motor sequelae; the remainder (14.9%) were quadriplegic. Most (78.3%) underwent surgery, and the mean follow-up time was 1.8±2.5 years. The lesions were cured in 25 patients; they recurred in 25% of the patients, and recurrence was seen to be associated with the location of the lesions. Patients with recurrent lesions had more medical consultations and a longer treatment time. Individuals whose ulcers had healed had fewer lesions, higher body mass index (BMI), and a higher proportion of these patients underwent surgery. Conclusions: BMI and location and number of lesions are prognostic factors. Level of Evidence IV, Case Series.摘要 研究目的：尽管医疗护理技术已有进步，但住院患者或脊髓损伤患者常罹患压疮。本研究旨在描述压疮的流行病学特征，并评估与压疮复发及治愈相关的影响因素。 方法：本研究为回顾性队列研究，收集了1997年至2016年间的临床与实验室病历资料。 结果：本研究共纳入60例压疮患者，患者平均年龄为38.1±16.5（中位数37.0）岁，其中83.3%为男性，86.8%为白人。多数患者（85.1%）存在截瘫、下肢截肢或下肢创伤后运动功能后遗症；剩余14.9%为四肢瘫痪患者。78.3%的患者接受了手术治疗，平均随访时间为1.8±2.5年。25例患者的病灶得以治愈，25%的患者出现压疮复发，且复发与病灶位置相关。复发患者的就诊次数更多、治疗时长更长。病灶愈合的患者病灶数量更少、体质量指数（BMI）更高，且接受手术治疗的患者比例更高。 结论：体质量指数（BMI）、病灶位置与病灶数量均为预后影响因素。证据等级：IV级，病例系列研究。