Staying Pressure Injury Free: The Role of Modifiable Behaviors

Objective: To investigate the association of behavioral factors with retrospective reports of staying free from pressure injuries (PIs) during a 12-month period for people with chronic spinal cord injury (SCI).Design: Cross-sectional survey.Setting: Data collection was completed at an academic medical center in the Southeastern United States in collaboration with a specialized treat-ment center and 2 public health registries that use population-based approaches to identify all incident cases of SCI within the state.Participants: The participant cohort was composed of 3817 adults (N=3817) with traumatic SCI of at least 1-year duration. Interventions: Not applicable.Main Outcome Measures: Self-reported recall of staying PI-free for 12 months vs having 1 or more PIs.Results: Among the 3817 participants, 74% were male, 76% were non-Hispanic White, and mean age was 48 years, with an average of 12 years post SCI. Based on self-report assessment, 67% reported being PI-free in the past year. After controlling for the demographic and injury character-istics, we found that those in the clinical cohort and those who reported healthy diets and planned exercise at least once a week were more likely to be PI-free; being underweight and high frequency of prescription medication use for spasticity, pain, and depression were negatively associated with being PI-free. Smoking, alcohol use, nonmedical substance use, and prescription medication misuse were not statistically significant in the multivariate model.Conclusions: There are several significant behavioral predictors of being PI-free, and consideration of these factors may be used to develop tai-lored strategies to promote healthy skin maintenance and the prevention of multiple, severe, and recurrent PI. Archives of Physical Medicine and Rehabilitation 2022;103:2138-44 (c) 2022 by the American Congress of Rehabilitation Medicine.