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

Shilpa Krishnan, Patricia E. Karg, Michael L. Boninger, Yoram Vodovotz, Greg Constantine, Gwendolyn A. Sowa, David M. Brienza

    Research output: Contribution to journalArticlepeer-review

    12 Scopus citations

    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.

    Original languageEnglish (US)
    Pages (from-to)1656-1662
    Number of pages7
    JournalArchives of Physical Medicine and Rehabilitation
    Volume97
    Issue number10
    DOIs
    StatePublished - Oct 2016

    Keywords

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

    ASJC Scopus subject areas

    • Physical Therapy, Sports Therapy and Rehabilitation
    • Rehabilitation

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