Risk of developing pressure sore in ALS patients: a nationwide cohort study

Abstract

Background

Prior investigations with few cases have disclosed lack of pressure sore (PrS) formation was characteristic in amyotrophic lateral sclerosis (ALS) patients. However, studies with larger samples are lacking to ascertain this concept.

Objective

To investigate whether patients with ALS have higher risk of PrS.

Methods

Utilizing a Taiwan National Insurance claims dataset with 23 million participants, we extracted 514 ALS patients and 2,056 controls from January 1, 2000, to December 31, 2008. Both groups were followed up until PrS occurrence during study period (2000-2011). The PrS risk was calculated with Cox proportional regression model.

Results

The ALS patients had a greater PrS risk (adjusted hazard ratio [aHR] = 8.82, 95% confidence interval [CI] = 4.90–15.9, P < 0.001) than the controls did. PrS risk was much higher in ALS women (aHR = 26.6, 95% CI = 9.05–78.2, P < 0.001) than in ALS men (aHR = 4.38, 95% CI = 1.99–9.68, P < 0.001). Besides, in people aged 20–54, ALS was linked with a much greater PrS risk (aHR = 27.7, 95% CI = 5.79–132, P < 0.001) than in those aged ≥55 (aHR = 6.10, 95% CI = 3.10–12.0, P < 0.001).

Conclusions

ALS is discovered to be correlated with an enhanced PrS risk. For PrS prevention, it is needed to pay more attention to the management of the ALS patients, particularly in women and those with relatively younger age. Further investigations are needed to confirm the findings in this study.

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