Factores de riesgo para la aparición y/o recurrencia de úlceras por presión en sujetos con lesión medular: revisión sistemática

Introduction: A spinal cord injury refers to the damage suffered in the spinal cord as a result of trauma, disease or degeneration. Every person with spinal cord injury is at risk of developing pressure ulcers, and almost everyone will develop at least one ulcer due to severe pressure during his or her life. Objective: To identify the studies that detected risk factors for the development and recurrence of pressure ulcers in patients with spinal cord injury; and, if possible, synthesize the evidence to determine whether an association exists between them. Methods: A systematic search was conducted in Medline, LILACS, SciELO and Cochrane until December 4, 2018. The following studies were included: observational studies, case-control studies, and prospective or retrospective cohort studies, which provided an adjusted analysis of the risk factors associated with the development and recurrence of pressure ulcers in patients with spinal cord injury. Results: 25 articles met the eligibility criteria and were included for analysis. A total of 30 risk factors were identified: 4 were demographic factors, 8 were related to the injury, 5 belonged to medical comorbidities, 3 to nutritional factors, 9 were psychological, cognitive, contextual and social factors and 1 was related to support surface. As regards the factors, 56.67 percent of them were classified as non-modifiable. Conclusion: 30 risk factors were identified for the development and recurrence of pressure ulcers in patients with spinal cord injury. However, we were not able to synthesize the evidence due to the heterogeneity of the articles included in this review. Introducción: Una lesión medular hace referencia a los daños sufridos en la médula espinal a consecuencia de un traumatismo, enfermedad o degeneración. Todas las personas con lesión medular corren riesgo de desarrollar úlceras por presión y casi todas desarrollarán al menos una úlcera por presión grave durante su vida. Objetivo: Identificar los estudios que detectaron factores de riesgo para la aparición y/o recurrencia de úlceras por presión en sujetos con lesión medular. Y de ser posible, sintetizar la evidencia para detectar asociación entre los mismos. Método: Se realizó una búsqueda sistemática en Medline, LILACS, SciELO y Cochrane hasta el 4 de diciembre del año 2018. Se incluyeron estudios observacionales, casos-controles y de cohorte, retrospectivos o prospectivos, que realizaron un análisis ajustado de los factores de riesgo para el desa