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Prospective Prognostic Cohort Study of Pressure Injuries in Older Adult Patients with Hip Fractures

Forni, Cristiana, MA, RN; D’Alessandro, Fabio, RN; Genco, Rossana, RN; Mini, Sandra, RN; Notarnicola, Teresa, RN; Vitulli, Arianna, RN; Capezzali, Daniela, RN; Morri, Mattia, PH

Advances in Skin & Wound Care: May 2018 - Volume 31 - Issue 5 - p 218–224
doi: 10.1097/01.ASW.0000530685.39114.98

OBJECTIVE: The aim of this study was to assess the rate of pressure injury and real predictors thereof in the older adult population with hip fractures in an orthopedic hospital.

METHODS: In this prospective prognostic cohort study, all patients admitted with fragility hip fractures were monitored over a 12-month period. On a daily basis, ward nurses and physiotherapists assessed the condition of the patients’ skin and collected data about all the predictors connected to their healthcare and hospital organization until the patients were discharged from hospital or until the onset of pressure injury.

RESULTS: From October 1, 2013, to September 30, 2014, 467 older adult patients with fragility fractures were enrolled in the study. Of these, 27% (n = 127) developed a pressure injury. Multivariate analysis identified the following predictive factors: age older than 81 years, type of surgery, and placing the limb in a foam rubber splint. No other factor connected to the patient or medical, nursing, or rehabilitation treatment was significantly correlated to the onset of pressure injury, even when the univariate analysis showed some of them were possible predictors.

CONCLUSIONS: Pressure injury in older adults with hip fractures is a relatively common complication, especially in high-risk patients or following certain treatments. These potential indicators could help provide safe and targeted care by preemptively identifying patients at highest risk of pressure injury.

In the Nursing and Allied Profession Research Unit, Rizzoli Orthopaedic Institute, Bologna, Italy, Cristiana Forni, MA, RN, is Head of Department, Nursing Clinical Research Unit; Fabio D’Alessandro, RN, is a Staff Nurse; Rossana Genco, RN, is a Nurse Coordinator; Sandra Mini, RN, is a Staff Nurse; Teresa Notarnicola, RN, is a Staff Nurse; Arianna Vitulli, RN, is a Staff Nurse; Daniela Capezzali, RN, is a Staff Nurse; and Mattia Morri, PH, is a Physiotherapist.

The authors have disclosed no financial relationships related to this article.

Submitted August 8, 2017; accepted in revised form November 17, 2017.

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