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Arch Phys Med Rehabil. 2016 Oct;97(10):1656-62. doi: 10.1016/j.apmr.2016.01.003. Epub 2016 Jan 25.

Early Detection of Pressure Ulcer Development Following Traumatic Spinal Cord Injury Using Inflammatory Mediators.

Author information

1
Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, PA. Electronic address: shikrish@utmb.edu.
2
Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, PA.
3
Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, PA; Department of Physical Medicine and Rehabilitation, University of Pittsburgh, School of Medicine, Pittsburgh, PA; Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA; McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA.
4
McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA; Department of Surgery, University of Pittsburgh, Pittsburgh, PA.
5
McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA; Department of Mathematics, University of Pittsburgh, Pittsburgh, PA.
6
Department of Physical Medicine and Rehabilitation, University of Pittsburgh, School of Medicine, Pittsburgh, PA; Ferguson Laboratory for Orthopaedic Research, Department of Orthopaedic Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA.
7
Department of Rehabilitation Science and Technology, School of Health and Rehabilitation Science, University of Pittsburgh, Pittsburgh, PA; Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA; Department of Mathematics, University of Pittsburgh, Pittsburgh, PA.

Abstract

OBJECTIVE:

To identify changes in concentrations of inflammatory mediators in plasma and urine after traumatic spinal cord injury (SCI) and before the occurrence of a first pressure ulcer.

DESIGN:

Retrospective; secondary analysis of existing data.

SETTING:

Acute hospitalization and inpatient rehabilitation sites at a university medical center.

PARTICIPANTS:

Individuals with a pressure ulcer and plasma samples (n=17) and individuals with a pressure ulcer and urine samples (n=15) were matched by age and plasma/urine sample days to individuals with SCI and no pressure ulcer (N=35).

INTERVENTIONS:

Not applicable.

MAIN OUTCOME MEASURES:

Plasma and urine samples were assayed in patients with SCI, capturing samples within 4 days after the SCI to a week before the formation of the first pressure ulcer. The Wilcoxon signed-rank test was performed to identify changes in the inflammatory mediators between the 2 time points.

RESULTS:

An increase in concentration of the chemokine interferon-γ-induced protein of 10kd/CXCL10 in plasma (P<.01) and a decrease in concentration of the cytokine interferon-α in urine (P=.01) were observed before occurrence of a first pressure ulcer (∼4d) compared with matched controls.

CONCLUSIONS:

Altered levels of inflammatory mediators in plasma and urine may be associated with pressure ulcer development after traumatic SCI. These inflammatory mediators should be explored as possible biomarkers for identifying individuals at risk for pressure ulcer formation.

KEYWORDS:

Biomarkers; Early diagnosis; Pressure ulcer; Rehabilitation; Risk factors; Spinal cord injuries

PMID:
26820323
DOI:
10.1016/j.apmr.2016.01.003
[Indexed for MEDLINE]

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