研究背景：脊髓損傷患者容易產生併發症，導致會有較高的再住院率，在諸多併發症中，又以壓瘡為最常見之併發症，故探討發生壓瘡之危險因子顯得極為重要。但過去文獻缺乏全國大樣本的資料，來探討關於脊髓損傷患者發生壓瘡之相關研究。此外，壓瘡的危險因子目前仍無一致答案，因此本研究欲探討脊髓損傷患者發生壓瘡之相關危險因子。

研究目的：針對國內進行全國性脊髓損傷患者之再住院情形進行探討，主要目的在於研究脊髓損傷患者發生之壓瘡特徵，並分析相關共病影響病人發生壓瘡之危險因子，進而提供給國內醫療人員、相關照護者在照護方面之實證參考。

研究設計：固定世代追蹤研究

研究方法：本研究方法利用全民健保資料庫，以2000年的住院檔為主，資料選取為2000年間所發生的新脊髓損傷個案，觀察時間為五年，來探討患者再住院與發生壓瘡的情形。

結果：全部樣本有2646人，一年內再住院率約為46%。進一步分析壓瘡之發生率，以住院主、次診斷為壓瘡者，五年內有243人，第一年發生壓瘡機率約為6%，至第五年之累積發生率約為10%。因壓瘡之再住院率方面，以住院主診斷為壓瘡者，五年內有90人，第一年因壓瘡之再住院率為1.2%，至第五年之累積再住院率為3.4%；如果以有接受清瘡手術之壓瘡患者而言，五年內有146人，第一年因壓瘡之再住院為3.7%，至第五年之累積再住院率為5.5%。在顯著的危險因子方面包括男性、年齡層低於二十歲與高於八十歲、受傷部位在胸椎；相關共病的危險因子包括自主神經反射異常、肺炎與糖尿病。

結論：脊髓損傷患者容易發生壓瘡，所以確認患者是否為高風險族群一直為重要議題，本研究發現幾個重要危險因子，建議照護者如果發現病人擁有相關危險因子，更需要加強注意病的人皮膚狀況，提供更好的預防與醫療照護，以避免壓瘡的發生，增加脊髓損傷病人的生活品質。

Research Background: Due to the fact the SCI patients have a higher likelihood of pressure sores in the periods subsequent to the treatment of SCI injury, rehospitalization rate is relatively high for SCI patients. While a good deal of research is available regarding rehospitalization of SCI patients in other countries, this area of interest remains untapped in Taiwan. However, the occurrence and risk factor for pressure sores of SCI patients is therefore still unclear.

Objective: This study identifies and discusses the characteristics of rehospitalization and complications of patients associated with spinal cord injury in Taiwan. More specifically, the purpose of this research is to analyze rehospitalization of SCI patients developed pressure sores and the characteristics and risk factors causing the occurrence of such complication. Subsequently, the finding of this study can be used as empirical reference in relation to care giving for medical personnel and caregivers.

Design: This is a fixed cohort study

Method: The data used for this study are individual new SCI cases occurred in year 2000, retrieved from the National Health Insurance Research Database. Through a five-year observation, this study attempts to explain the relation between rehospitalization and complications of SCI patients.

Results: In total sample size of 2646 SCI patients, rehospitalization rate in the first year after SCI injury is approximately 46%. In further analyzing incidence of pressure sores within a five-year time frame, there are 243 patients with primary and secondary diagnosis of pressure sores. The resulting incidence of pressure sores within one year after injury is approximately 6%, and cumulative incidence of pressure sores is 10% in the fifth year. There are two methods to calculate rehospitalization rate due to pressure sores. First, we incorporate patients with primary diagnosis of pressure sores. Within a 5 year time frame, the number of patients that are listed with primary diagnosis of pressure sores amounted to 90, the resulting rehospitalization rate due to pressure sores is 1.2% within the first year and the cumulative rehospitalization rate is 3.4% in the fifth year. Second, we incorporate patients who received debridement surgery to calculate rehospitalization rate due to pressure sores. The number of patients in this category amounted to 146 within a 5 year time frame, the resulting rehospitalization rate due to pressure sores is 3.7% within the first year and the cumulative rehospitalization rate is 5.5% in the fifth year. The most significant risk factors of pressure sores include patients that are male, at ages below 20 and above 80 and have injury level at thoracic; risk factors of related comorbidity include autonomic dysreflexia, pneumonia and diabetes.

Conclusion: Our research finding shows that rehospitalization rate for patients with spinal cord injury in Taiwan remains relatively high in the first year. Furthermore, the results also indicate that length of stay at hospitals is longer for those SCI patients, who were re-hospitalized and have pressure sores. A few significant risk factors were found. Our findings have significant implications for healthcare policy, assist in prevention and management of complication and improve QOL in people with SCI.

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