Nutritional Intakes of People With Spinal Cord Injury Who Have Pressure Injuries in Hospital: A Secondary Analysis of a Randomized Controlled Trial

Background: People living with spinal cord injury (SCI) have one of the highest rates of pressure injury prevalence globally, yet the nutrition-related characteristics of this group are inadequately described. Objectives: This secondary analysis aimed to explore the nutritional status, dietary intakes, and healing outcomes of people with SCI who have pressure injuries in hospital. Methods: Participant demographics, pressure injury-related information, anthropometry, nutritional status (subjective global assessment), and nutrition interventions were recorded. Assessments of energy and protein intake (24-hour dietary recalls), comparison with evidence-based guideline recommendations, and pressure injury healing (surface area measurements) were collected weekly until one of these occurred: complete healing, hospital discharge, surgical repair, or day 28. Factors associated with overall healing were explored using Mann-Whitney U tests. Results: Twenty-six people (mean age, 51 +/- 14 years; 81% male) were included. Most were well nourished (77%), receiving dietetic input (85%), and on high-protein, high-energy diets (92%). Between 50% and 90% were exceeding energy and protein recommendations at all time points, and there was a weak negative correlation between energy intake and healing (r =-0.430, P = .036). Reduced healing was observed among participants with severe pressure injuries (stage 4 or unstageable, size >5 cm(2), >1 pressure injury present) and in those exceeding energy and protein recommendations (P < .05). Conclusion: People with SCI who have coexisting pressure injuries are at risk of excess intake that may be detrimental for pressure injury healing. Future studies examining the nutritional requirements of this population and the impact of both under- and overnutrition are critically needed to guide clinical care.