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01-12-2017 | Original Article

Pressure ulcers are associated with 6-month mortality in elderly patients with hip fracture managed in orthogeriatric care pathway

Authors: Emmanuelle Magny, Helene Vallet, Judith Cohen-Bittan, Mathieu Raux, Antony Meziere, Marc Verny, Bruno Riou, Frédéric Khiami, Jacques Boddaert

Published in: Archives of Osteoporosis | Issue 1/2017

Abstract

Summary

Despite orthogeriatric management, 12% of the elderly experienced PUs after hip fracture surgery. PUs were significantly associated with a low albumin level, history of atrial fibrillation coronary artery disease, and diabetes. The risk ratio of death at 6 months associated with pressure ulcer was 2.38 (95% CI 1.31–4.32%, p = 0.044).

Introduction

Pressure ulcers in hip fracture patients are frequent and associated with a poor outcome. An orthogeriatric management, recommended by international guidelines in hip fracture patients and including pressure ulcer prevention and treatment, could influence causes and consequences of pressure ulcer. However, remaining factors associated with pressure ulcer occurrence and prognostic value of pressure ulcer in hip fracture patients managed in an orthogeriatric care pathway remain unknown.

Methods

From June 2009 to April 2015, all consecutive patients with hip fracture admitted to a unit for Post-operative geriatric care were evaluated for eligibility. Patients were included if their primary presentation was due to hip fracture and if they were ≥ 70 years of age. Patients were excluded in the presence of pathological fracture or if they were already hospitalized at the time of the fracture. In our unit, orthogeriatric principles are implemented, including a multi-component intervention to improve pressure ulcer prevention and management. Patients were followed-up until 6 months after discharge.

Results

Five hundred sixty-seven patients were included, with an overall 14.4% 6-month mortality (95% CI 11.6–17.8%). Of these, 67 patients (12%) experienced at least one pressure ulcer. Despite orthogeriatric management, pressure ulcers were significantly associated with a low albumin level (RR 0.90, 95% CI 0.84–0.96; p = 0.003) and history of atrial fibrillation (RR 1.91, 95% CI 1.05–3.46; p = 0.033), coronary artery disease (RR 2.16, 95% CI 1.17–3.99; p = 0.014), and diabetes (RR 2.33, 95% CI 1.14–4.75; p = 0.02). A pressure ulcer was associated with 6-month mortality (RR 2.38, 95% CI 1.31–4.32, p = 0.044).

Conclusion

In elderly patients with hip fracture managed in an orthogeriatric care pathway, pressure ulcer remained associated with poorly modifiable risk factors and long-term mortality.

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Title: Pressure ulcers are associated with 6-month mortality in elderly patients with hip fracture managed in orthogeriatric care pathway
Authors: Emmanuelle Magny
Helene Vallet
Judith Cohen-Bittan
Mathieu Raux
Antony Meziere
Marc Verny
Bruno Riou
Frédéric Khiami
Jacques Boddaert
Publication date: 01-12-2017
Publisher: Springer London
Published in: Archives of Osteoporosis / Issue 1/2017
Print ISSN: 1862-3522
Electronic ISSN: 1862-3514
DOI: https://doi.org/10.1007/s11657-017-0365-9

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Pressure ulcers are associated with 6-month mortality in elderly patients with hip fracture managed in orthogeriatric care pathway

Abstract

Summary

Introduction

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Summary

Introduction

Methods

Results

Conclusion

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