Pressure sores in adult spina bifida (SB) patients – a questionnaire based interview of the norwegian population

Background

In a previous study we found that 35 % of the adult SB population in Norway have sores [1], corresponding with other studies [2]. In this study we focused on sores and risk factors, i.e. sensory, motor, autonomous and cognition deficits, associated neurological diagnoses and lifestyle factors.

Materials and methods

Of the 193 SB patients (112 women, 81 men) registered in august 2003 at TRS, 87 (57 w, 30 m) completed a questionnaire. Associations between sores and risk factors were analysed by Pearson Chi-Square tests. Patients were categorised in three groups: (a) sores at the time of interview, (b) sores in the last five years and (c) without sores. A p value less than 0.05 was considered significant.

Results

In group (a) there were 26 patients (30 %), in (b) 45 (52%) and (c) 16 (18 %). In group (a) 10 had several sores. 12 sores were localised on toes, 10 on feet and 8 on buttocks. Other localisation was seldom. Sores were associated with sensory deficit (p = 0,04). Regions with normal sensibility had no sores, with reduced or missing sensibility 7 and 19, respectively. Memory deficit was the only cognition deficit associated with sores (p = 0.02). Among 44 patients, 16 were in group (a), 25 in (b), and 3 in (c). 14 patients with both tethered cord and operated Arnold Chiari malformation had higher risk for sores (8 in group (a), 6 in (b)) than patients with none or one of these diagnoses (p = 0.02). Hydrocephalus and syringomyelia were not associated with sores. Nutrition, BMI, smoking, training, job and living together were not associated with sores. Only 20 (23%) were inspected by others.

Conclusion

Totally, 82 % of SB patients reported sores at time of interview or during the last 5 years. Occurrence of sores was associated with sensory function, memory deficits and with a combination of tethered cord and Arnold Chiari malformation. Surprisingly, few patients reported skin inspection by others.