Lindholm C, Sterner E, Romanelli M, Pina E, Torra y Bou J, Hietanen H, Iivanainen A, Gunningberg L, Hommel A, Klang B, Dealey C, et al.
International wound journal. Date of publication 2008 Jun 1;volume 5(2):315-28.
1. Int Wound J. 2008 Jun;5(2):315-28. doi: 10.1111/j.1742-481X.2008.00452.x.
Hip fracture and pressure ulcers - the Pan-European Pressure Ulcer Study -
intrinsic and extrinsic risk factors.
Lindholm C(1), Sterner E, Romanelli M, Pina E, Torra y Bou J, Hietanen H,
Iivanainen A, Gunningberg L, Hommel A, Klang B, Dealey C.
Author information:
(1)Department of Health Sciences, Kristianstad University, Sweden.
christina.lindholm@hkr.se
Pressure ulcers (PU) in patients with hip fracture remain a problem. Incidence of
between 8.8% and 55% have been reported. There are few studies focusing on the
specific patient-, surgery- and care-related risk indicators in this group. The
aims of the study were: - to investigate prevalence and incidence of PU upon
arrival and at discharge from hospital and to identify potential intrinsic and
extrinsic risk factors for development of PU in patients admitted for hip
fracture surgery, - to illuminate potential differences in patient logistics,
surgery, PU prevalence and incidence and care between Northern and Southern
Europe. Consecutive patients with hip fracture in six countries, Sweden, Finland,
UK (North) and Spain, Italy and Portugal (South), were included. The patients
were followed from Accident and Emergency Department and until discharge or 7
days. Prevalence, PU at discharge and incidence were investigated, and intrinsic
and extrinsic risk indicators, including waiting time for surgery and duration of
surgery were recorded. Of the 635 patients, 10% had PU upon arrival and 22% at
discharge (26% North and 16% South). The majority of ulcers were grade 1 and none
was grade 4. Cervical fractures were more common in the North and trochanteric in
the South. Waiting time for surgery and duration of surgery were significantly
longer in the South. Traction was more common in the South and perioperative
warming in the North. Risk factors of statistical significance correlated to PU
at discharge were age >or=71 (P = 0.020), dehydration (P = 0.005), moist skin (P
= 0.004) and total Braden score (P = 0.050) as well as subscores for friction (P
= 0.020), nutrition (P = 0.020) and sensory perception (P = 0.040). Comorbid
conditions of statistical significance for development of PU were diabetes (P =
0.005) and pulmonary disease (P = 0.006). Waiting time for surgery, duration of
surgery, warming or non warming perioperatively, type of anaesthesia, traction
and type of fracture were not significantly correlated with development of PU.
DOI: 10.1111/j.1742-481X.2008.00452.x
PMID: 18494637 [Indexed for MEDLINE]
