Nutritional blood parameters and nutritional risk screening in patients with spinal cord injury and deep pressure ulcer-a retrospective chart analysis

Spinal Cord. 2018 Feb;56(2):168-175. doi: 10.1038/s41393-017-0016-4. Epub 2017 Oct 23.


Study design: Retrospective chart review.

Objectives: To describe (i) the nutritional blood parameters (NBP) and the nutritional risk screening (NRS) in patients with spinal cord injury (SCI) and pressure ulcers (PU) III and IV according to the EPUAP classification, and (ii) the relationship between both NBP and NRS.

Setting: SCI acute care and rehabilitation clinic in Switzerland.

Methods: The NBPs were measured upon the admission of patients treated for PU III and IV between 11/2011 and 12/2014. Descriptive analyses and group comparisons were done.

Results: A total of 170 patients, including 42 (25%) women, 19 (12%) people with paraplegia and 104 (61%) people with traumatic SCI, were admitted and analyzed. Pathologic blood values and NBP were found for c-reactive protein (83%), vitamin D (73%), protein (41%), erythrocyte sedimentation rate (ESR) (41%), albumin (34%), hemoglobin (34%), zinc (29%), folic acid (22%), transferrin (15.3%), and copper (1.2%). Overall, the NRS was >3 in 39% of the patients, wherefrom 28% in patients with PU III and 44% with PU IV (p=0.07). No statistical significant differences were found between patients with PU III and IV in terms of NBP and NRS.

Conclusions: We found abnormal values in NBP and in NRS in a significant number of patients with SCI and PU of both III and IV. Both laboratory examinations and nutritional assessments at admission can help to detect and correct the nutritional deficits in patients at risk. Neither the grade of the PUs, nor the NBP or the NRS can replace one another.

MeSH terms

  • Adult
  • Aged
  • Blood Sedimentation
  • C-Reactive Protein / metabolism
  • Cohort Studies
  • Female
  • Folic Acid / blood
  • Hemoglobins / metabolism
  • Humans
  • Male
  • Middle Aged
  • Nutrition Assessment*
  • Nutrition Disorders / blood
  • Nutrition Disorders / etiology*
  • Pressure Ulcer / blood*
  • Pressure Ulcer / complications*
  • Risk Factors
  • Serum Albumin / metabolism
  • Spinal Cord Injuries / blood*
  • Spinal Cord Injuries / complications*
  • Spinal Cord Injuries / epidemiology
  • Switzerland / epidemiology
  • Vitamin D / blood


  • Hemoglobins
  • Serum Albumin
  • Vitamin D
  • C-Reactive Protein
  • Folic Acid