Predictive factors for category II pressure ulcers in older patients with hip fractures: a prospective study

Gazineo, Domenica; Chiari, Paolo; Chiarabelli, Matteo; Morri, Mattia; D'Alessandro, Fabio; Sabattini, Tania; Ambrosi, Elisa; Forni, Cristiana

doi:10.12968/jowc.2019.28.9.593

Cited by 8 publications

(7 citation statements)

References 26 publications

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“…The overall rate of PrI development in this large database study (2.5%) was lower than that in previous studies, which reported rates from 3.8% to 27% 1–3,5 . This incongruity may be due to differences in geographic location.…”

Section: Discussioncontrasting

confidence: 87%

“…Pressure injury (PrI) is prevalent in older adult patients with a hip fracture. Three contemporary studies from Italy demonstrate that 12% to 27% of patients with a hip fracture experience some form of PrI 1–3 . A meta-analysis of eight studies with 22,180 patients reported that 15.1% of patients with diabetes experienced a PrI compared with 7.5% in the group without diabetes 4 .…”

Section: Introductionmentioning

confidence: 99%

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Clinical Risk Factors of Perioperative Pressure Injury in Older Adult Patients with a Hip Fracture

Tzen,

Sambandam,

Delmore

et al. 2023

Adv Skin Wound Care

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OBJECTIVE To examine the clinical risk factors of perioperative pressure injury (PrI) in older adults with a hip fracture, including preoperative chronic comorbidities and postoperative complications. METHODS In this retrospective study, the authors queried the PearlDiver Patient Records database between January 2011 and January 2020. Data from 54,194 patients without preexisting PrI were included for analyses. Patients were separated into two groups: (1) one or more perioperative PrI and (2) no PrI. Clinical factors as outcome variables include 21 comorbidities and 10 complications. RESULTS Univariate analyses were computed to compare the variables between groups, and two logistic regression models were developed to find comorbidity predictors and complication predictors. Of all patients, 1,362 (2.5%) developed one or more perioperative PrI. Patients with perioperative PrIs were more likely to be older men. One-year mortality for patients with perioperative PrI was 2.5 times that of patients without PrI. The regression models showed that predictors of perioperative PrI are malnutrition, hypoalbuminemia, frailty, peripheral vascular disease, dementia, urinary tract infection, perioperative red blood cell transfusion, and atrial fibrillation. CONCLUSIONS Screening for these comorbidities and complications may assist in determining the risk of PrI in older adults undergoing hip fracture surgery. Determining PrI risk enables the appropriate prevention strategies to be applied perioperatively.

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Section: Discussioncontrasting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Clinical Risk Factors of Perioperative Pressure Injury in Older Adult Patients with a Hip Fracture

Tzen,

Sambandam,

Delmore

et al. 2023

Adv Skin Wound Care

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“…The primary outcome was the incidence of any stage hospital-acquired PUs. PUs are one of the most frequent complications in hip fracture patients, ranging from 8.8% to 55% in the International literature [20], and an independent predictive factor of one-year mortality after surgery [21]. Moreover, several authors have identified hospital-acquired PUs as a major nurse-sensitive outcome [22].…”

Section: Methodsmentioning

confidence: 99%

The impact of first wave of COVID-19 on the nursing-sensitive and rehabilitation outcomes of patients undergoing hip fracture surgery: a single centre retrospective cohort study

et al. 2022

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Background During the COVID-19 pandemic, the care of hip fracture patients remains a clinical priority. To date, there is limited empirical knowledge about the impact of pandemic on the care of patients surgically treated for hip fracture, affected or not by COVID-19. Objective To investigate the effects of the COVID-19 pandemic on the nursing-sensitive and rehabilitation outcomes of frail patients undergoing hip fracture surgery. Methods A retrospective cohort study was conducted in an Italian Orthopaedic Research Institute. All patients aged ≥ 65 years admitted with fragility hip fractures between 1st March and 30th June in 2019 (group PP: pre-pandemic) and in the same period in 2020 (group P: pandemic), were compared. In the P group, COVID-19 positive patients were excluded due to the presence of a specific treatment pathway. Data on patient demographics and baseline characteristics, and peri-operative care factors were obtained from the Institute’s computer-based patient-record system. The primary outcome was the incidence of any stage hospital-acquired pressure ulcers (PUs). The secondary outcome was time to first static verticalization and to first ambulation. Results Three-hundred and sixty patients were included in the study, which comprised 108 patients in PP group and 252 patients in P group. Overall PUs incidence was significantly higher in the P-group (21.8%) than in the PP-group (10.2%) (p = 0.009). Specifically, the incidence of sacral PUs was significantly lower in P-group (38.1%) vs PP-group (91%) (p = 0.004); on the contrary, the incidence of PUs localized to the heels or other body sites were significantly higher in P-group (30.9% and 30.9%, respectively) vs PP-group (0% and 9%, respectively) (p = 0.004). No significant between groups differences were found for all the secondary outcomes. Conclusion In the pandemic period, nursing and rehabilitation care provided to patients with fragility hip fracture maintained high standards comparable to the pre-pandemic period. The increase in PUs incidence in the pandemic period was probably due to the older age of the patients admitted to hospital. The qualitative evaluation of the care administered and the emotional impact of the pandemic on the patients are very interesting topic which would deserve further investigation.

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“…Approximately 12% of patients suffered category II or higher pressure ulcers in a prospective cohort study that identified five risk factors associated with developing sores: higher preoperative Braden score, surgical procedure with internal fixation, a higher percentage of days with the presence of foam valves before surgery, use of a urinary catheter, and use of a diaper in the postoperative period [92]. Another prospective cohort study also found an incidence of 12% and linked this geriatric syndrome to low albumin levels, history of atrial fibrillation, coronary artery disease and diabetes.…”

Section: Pressure Soresmentioning

confidence: 99%

Orthogeriatric Management: Improvements in Outcomes during Hospital Admission Due to Hip Fracture

Tarazona-Santabalbina

Ojeda-Thies

Rodríguez

et al. 2021

IJERPH

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Hip fractures are an important socio-economic problem in western countries. Over the past 60 years orthogeriatric care has improved the management of older patients admitted to hospital after suffering hip fractures. Quality of care in orthogeriatric co-management units has increased, reducing adverse events during acute admission, length of stay, both in-hospital and mid-term mortality, as well as healthcare and social costs. Nevertheless, a large number of areas of controversy regarding the clinical management of older adults admitted due to hip fracture remain to be clarified. This narrative review, centered in the last 5 years, combined the search terms “hip fracture”, “geriatric assessment”, “second hip fracture”, “surgery”, “perioperative management” and “orthogeriatric care”, in order to summarise the state of the art of some questions such as the optimum analgesic protocol, the best approach for treating anemia, the surgical options recommendable for each type of fracture and the efficiency of orthogeriatric co-management and functional recovery.

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Predictive factors for category II pressure ulcers in older patients with hip fractures: a prospective study

Cited by 8 publications

References 26 publications

Clinical Risk Factors of Perioperative Pressure Injury in Older Adult Patients with a Hip Fracture

Clinical Risk Factors of Perioperative Pressure Injury in Older Adult Patients with a Hip Fracture

The impact of first wave of COVID-19 on the nursing-sensitive and rehabilitation outcomes of patients undergoing hip fracture surgery: a single centre retrospective cohort study

Orthogeriatric Management: Improvements in Outcomes during Hospital Admission Due to Hip Fracture

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