Association of body mass index and pressure injuries in persons with traumatic spinal cord injury

Background There are conflicting findings in the literature about the association of body mass index (BMI) and pressure injury (PI) development in the population with traumatic spinal cord injury (SCI). It is important to investigate the relationship between BMI and risk of PI in persons with SCI because chronic PIs are associated with decreased participation in daily and community activities as well as the greatest average decline in life expectancy compared to other secondary health conditions. Objective To determine the relationship between BMI (kg/m 2 ) and self‐reported PI in the traumatic SCI population. Design Cross‐sectional survey across 18 SCI Model Systems in the United States. Setting Institutional. Participants 2218 participants enrolled in the National SCI Model Systems Database age ≥20 years were divided into 8 BMI groups (<18.5, 18.5‐19.9, 20‐22.49, 22.5‐24.9, 25‐27.49, 27.5‐29.9, 30‐34.49, and ≥35 kg/m 2 ). Interventions Not applicable Main Outcome Measure The percentage of individuals reporting ≥1 PI with broken skin over the last 12 months. Results The prevalence for underweight (<18.5 kg/m 2 ), normal (20–22.49 kg/m 2 ), and severe high BMI (≥35 kg/m 2 ) was 6.6%, 15.1%, and 10.2%, respectively. Overall, 29.8% of the sample experienced a PI within the 12 months prior to the interview. Individuals who were underweight had a higher rate of PI (43.2%) when compared to those in the normal range (31.7%) and severe high BMI (29.2%; p = .02). In subgroup analyses, this was significant in the groups who were 1–5 years since injury (41.2% underweight vs. 29.1% normal; p = .04), age 40–64 (57.5% underweight vs. 33.8% normal; p = .01) and male (48.4% underweight vs. 33.6% normal; p = .01). Conclusion Our study highlights the need for resources dedicated to PI prevention and surveillance in underweight individuals with SCI.