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Introduction:Decubitus ulcer is a pressure-induced tissue injury that may affect skin, muscle, connective tissue, cartilage and bone. The present study was designed to find out risk factors of decubitus ulcer in head and spinal cord injured patient admitted to intensive care units (ICU). Materials and Methods: In this cross - seetional analythical study all consecutive craniospinal trauma patients admitted to intensive care unit were included.Upon arrival at the hospital and every 48 hours, all patients were examined for existence of bed sore. Braden scale, age, kind of mattress, site of primary injury and level of consciousness were used to determine risk factors. Data was analyzed using T and Chi square tests and logistic regretion. Results: Among 198 patients (171 male, 27 female with mean age of 31.4=19.8), 166 patients (3.8%) had cranial and 32 (16.2%) patients had spinal trauma. Of samples, 45 (22.7%) patients had 67 sores in 13 different sites. Incidence of bed sore was 22.7% (in cranial and spinal injured patients was 4.54% and 18.18% respectively). The most common sites were intergluteal cleft (33.3%) and sacral regions (28.9%). Bed sores were observed more frequently in immobile patients and those with impaired sensation, the difference were statistically significant (p<0.005 and p<0.005 respectively) hence immobility and impaired sensation are known as risk factors. Patient’s sores were not influenced by age, moisture, activity, nutrition and type of mattress variables. Time of hospital stay in patients with bed sore was significantly more than those without bed sore (P<0.00001). Coma patients (GCS 8) had developed bed sore more frequently than conscious ones (OR=6.1, RR=4.4, P=0.00001). Conclusion: Results show that risk factors of deubitus ulcers in ICU admitted craniospinal trauma patients were decreased sensation, activity and level of conciousness and lenglt of hospital stay.

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Abstract Background: Information on patients' physical and mental disabilities, their lifestyle during rehabilitation period and probably their death due to severe head injury in acute phases is too insufficient and in some cases, it does not exist at all. The aim of this study is to determine the outcome of patients who were hospitalized in Vali-asr Hospital of Arak according to Glascow Coma Scale (GOS). Materials and Methods: In this cross-sectional retrospective study, using the patients' files in Vali-asr Hospital which is situated in Arak, the patients, who had been hospitalized with severe head injury during 2005-06, were identified. Based on the information existing in their files or visiting them individually in their place of living, 24 months after their release from hospital, their physical and mental performances were examined according to Glascow Outcome Scale (GOS) and were compared to the time of their release from the hospital. Results: Out of 130 patients, 55.4% died within 2 years after the hospitalization period. Among those dead, 32% died in the first 24 hours of hospitalization, 44.4% after the first 24 hours and before release from the hospital and 23.6% after being released from the hospital. The mean of GOS score, from the time of release until 2 years after that, improved from 2.7 to 3.3. Conclusion: Noticing the fact that more than half of the patients died after getting to hospital either in acute level or during rehabilitation, the need is felt for making revisions in the programs for taking care of these patients in different phases of treatment