Pressure ulcer risk in hip fracture patients

Houwing, Ronald H; Rozendaal, Marja; Wouters-Wesseling, W.; Buskens, Erik; Keller, P. A.; Haalboom, J. R. E.

doi:10.1080/759369180

Cited by 10 publications

(22 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Our results are in line with Hengstermann et al (2007). It has also been shown in several studies that nutritional supplements may decrease the risk of pressure ulcers (Bourdel-Marchasson et al 2000, Houwing et al 2003.…”

supporting

confidence: 82%

Commentary on Tannen A, Dassen T and Halfens R (2008) Differences in prevalence of pressure ulcers between the Netherlands and Germany – associations between risk, prevention and occurrence of pressure ulcers in hospitals and nursing homes. Journal of Clinical Nursing 17, 1237–1244

Muurinen

Soini

Pitkälä

2008

Journal of Clinical Nursing

View full text Add to dashboard Cite

Tannen et al. (2008) investigated, in their extensive study, (n = 31,381) German and Dutch nursing homes and hospitals by nationwide surveys whether any potential differences in preventive activities can account for the varying occurrence of pressure ulcers. The prevalence rate was significantly higher in the Dutch than in the German sample. The researchers conclude that some of the variance in pressure ulcer prevalence can be explained by varying pressure ulcer prevention. One of the prevention interventions examined was nutrition intervention which, however, in the logistic regression model, did not have predictive value on prevention of pressure ulcers.We have also investigated the prevalence of pressure ulcers as a part of our nutritional study in all nursing homes (n = 20) and in all long-term care hospitals (n = 7) in the city of Helsinki (Muurinen et al. 2003, Soini et al. 2004, in Finland. Of all the residents (>65 years) in the nursing homes, 82% (n = 1983) and of the residents in long-term care hospitals, 75% (1084) participated in the study. Trained nurses carried out the assessment of residents' nutritional status by Mini Nutritional Assessment (MNA) test (Guigoz et al. 1997). The test is well-validated and widely accepted screening instrument for nutritional status of older people. When the score (range 0-30) is <17 the resident is considered to suffer from malnutrition, 17-23AE5 indicates a risk for malnutrition and >23AE5 a good nutritional status. The question of pressure ulcer prevalence (yes/no) is included in the MNA-test. We also collected data concerning demographics, medical diagnoses and nutritional care of all residents by a structured questionnaire.The residents were old: mean age of the whole population was 82AE8 years and 78AE7% was female. Of the nursing home residents, 15AE1% suffered from pressure ulcers whereas the respective figure for the long-term care hospitals was 22AE1% (p < 0AE001). The pressure ulcers were significantly associated with being malnourished according to the MNA, having lower BMI, being bed-ridden and having the diagnosis of diabetes and not having diagnosis of dementia. Those with pressure ulcers were more often administered nutritional supplements (Table 1). Altogether 29% of nursing home residents and 57% of long-term care hospital patients suffered from malnutrition according to the MNA.Contrary to the Tannen et al.'s results, our study suggests that older residents' nutritional status seems to be a very important factor associated with the prevalence of pressure ulcers. Both low MNA points and lower BMI were associated with pressure ulcers. Tannen et al. used nutritional intervention as one covariate in their logistic regression model testing for prevention of pressure ulcers, and it did not show any predictive value. As our study shows, the nutritional intervention may be a response to poor nutritional status as those with pressure ulcers were administered more often nutritional supplements. The patient at risk of pressure ulcers may have both poor nutr...

show abstract

supporting

confidence: 82%

Commentary on Tannen A, Dassen T and Halfens R (2008) Differences in prevalence of pressure ulcers between the Netherlands and Germany – associations between risk, prevention and occurrence of pressure ulcers in hospitals and nursing homes. Journal of Clinical Nursing 17, 1237–1244

Muurinen

Soini

Pitkälä

2008

Journal of Clinical Nursing

View full text Add to dashboard Cite

show abstract

“…The prevalence of pressure ulcers (grade I and II according to EPUAP) in a recently published series of elderly patients with hip fractures was approximated at 50% [12].…”

Section: Resultsmentioning

confidence: 99%

Pressure Ulcers and Prolonged Hospital Stay in Hip Fracture Patients Affected by Time-to-Surgery

Rademakers

Vainas

Zutphen

et al. 2007

Eur J Trauma Emerg Surg

View full text Add to dashboard Cite

Background: Hip fractures are associated with high morbidity. Pressure ulcer formation after hip surgery is often related to delayed patient mobilization. The objectives of this study were to determine whether time-to-surgery affects development of pressure ulcers postoperatively and, thus, length of hospital stay. Patients and Methods:We performed a retrospective analysis of consecutive hip fracture patients, aged 60 years and above, who underwent surgery between 1995 and 2001. The primary outcome was in-hospital development of pressure ulcers. The secondary outcome measure was the overall length of hospital stay. Analyses were adjusted for relevant confounders. Results: Of the 722 patients enrolled, 488 patients (68%) received surgery at 12 h after admission. Approximately 30% (n = 214) developed pressure ulcers during admission, whilst 19% of patients operated within 12 h of admission developed pressure ulcers. Time-to-surgery was an independent predictor of both development of pressure ulcers (OR = 1.7, 95% confidence interval [CI] = 1.2-2.6; p = 0.008) and length of hospital stay (11.3 vs 13.3 days in the early and the late surgery group, respectively, p = 0.050). Furthermore, development of pressure ulcers was associated with prolonged postoperative hospital stay (19.5 vs 11.1 days for patients with and without pressure ulcers, respectively, p = 0.001) Interpretation: In hip fracture patients, time-to-surgery was an independent predictor of both postoperative pressure ulcer development and prolonged hospital stay. These data suggest that the implementation of an early surgery protocol following admission for hip fractures may reduce both the postoperative complications and overall hospital stay.

show abstract

“…Nuestros resultados ponen en evidencia claramente que sólo con la utilización de una superficie de alivio de la presión, de tipo estático, no es suficiente para conseguir una prevención eficaz, lo que está en la misma línea de otros autores (37). Algunos resultados similares y la eficacia de programas reforzados de prevención de UPP, sobre todo en pacientes con fractura de cadera, han sido descritos en otros países (16)(17)(18)38). De igual forma, los resultados de algunos estudios evidencian que el uso sistemático de apósitos protectores en los talones reduce la incidencia de UPP en pacientes quirúrgicos (39), por lo que proponemos el uso precoz de esta medida de prevención inmediatamente después del final de la intervención quirúrgica.…”

Section: Discussionunclassified

“…En Suecia, se encontraron tasas de UPP en pacientes con fractura de cadera tan elevadas como el 55%, que pudieron ser disminuidas de forma importante mediante un programa de mejora de la calidad (16). Otras investigaciones han encontrado resultados similares, en cuanto a elevada incidencia de UPP (17,18). La influencia de la alimentación y de factores nutricionales de los pacientes en el desarrollo de UPP tras una fractura de cadera parece tener una alta importancia (19,20).…”

Section: Introductionunclassified

Úlceras por presión en el postoperatorio de intervenciones quirúrgicas de cadera o de rodilla

Martínez¹,

López-Donaire²,

Molina-Mercado³

et al. 2009

Gerokomos

View full text Add to dashboard Cite

Pressure ulcer risk in hip fracture patients

Cited by 10 publications

References 0 publications

Commentary on Tannen A, Dassen T and Halfens R (2008) Differences in prevalence of pressure ulcers between the Netherlands and Germany – associations between risk, prevention and occurrence of pressure ulcers in hospitals and nursing homes. Journal of Clinical Nursing 17, 1237–1244

Commentary on Tannen A, Dassen T and Halfens R (2008) Differences in prevalence of pressure ulcers between the Netherlands and Germany – associations between risk, prevention and occurrence of pressure ulcers in hospitals and nursing homes. Journal of Clinical Nursing 17, 1237–1244

Pressure Ulcers and Prolonged Hospital Stay in Hip Fracture Patients Affected by Time-to-Surgery

Úlceras por presión en el postoperatorio de intervenciones quirúrgicas de cadera o de rodilla

Contact Info

Product

Resources

About