Article

OBJECTIVE: To identify the inflammatory mediators around the time of pneumonia
onset associated with concurrent or later onset of pressure ulcers (PUs). DESIGN: Retrospective. SETTING: Acute hospitalization and inpatient rehabilitation unit
of a university medical center. PARTICIPANTS: Individuals (N=86) with traumatic
spinal cord injury (SCI) were included in the initial analyses. Fifteen of the 86
developed pneumonia and had inflammatory mediator data available. Of these 15, 7
developed PUs and 8 did not. INTERVENTIONS: Not applicable. MAIN OUTCOME
MEASURES: Twenty-three inflammatory mediators in plasma and urine were assayed.
The differences in concentrations of plasma and urine inflammatory mediators
between the closest time point before and after the diagnosis of pneumonia were
calculated. RESULTS: Initial chi-square analysis revealed a significant (P=.02)
association between pneumonia and PUs. Individuals with SCI and diagnosed
pneumonia had nearly double the risk for developing PUs compared with those with
no pneumonia. In individuals with pneumonia, Mann-Whitney U exact tests suggested
an association (P<.05) between the formation of a first PU and a slight increase
in plasma concentrations of tumor necrosis factor-alpha (TNF-alpha), and a
decrease in urine concentrations of TNF-alpha, granulocyte-macrophage
colony-stimulating factor (GM-CSF), and interleukin (IL)-15 after onset of
pneumonia. CONCLUSIONS: These findings suggest that a relatively small increase
in plasma TNF-alpha, and decreases in urine TNF-alpha, GM-CSF, and IL-15 from
just before to just after the diagnosis of pneumonia could be markers for an
increased risk of PUs in individuals with pneumonia after traumatic SCI.
CI - Copyright (c) 2017 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS