Pressure Ulcers and Prolonged Hospital Stay in Hip Fracture Patients Affected by Time-to-Surgery |
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Authors: | Leonard M F Rademakers Tryfon Vainas Stefan W A M van Zutphen Peter R G Brink Sven H van Helden |
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Institution: | (1) Department of Cardiothoracic Surgery, Maastricht University Hospital, Maastricht, The Netherlands;(2) Department of Surgery, Maastricht University Hospital, Maastricht, The Netherlands;(3) Department of Surgery, TweeSteden Hospital, Tilburg, The Netherlands;(4) Department of Traumatology, Maastricht University Hospital, Maastricht, The Netherlands;(5) Department of Cardiothoracic Surgery, Maastricht University Hospital, PO Box 5800, 6202 AZ Maastricht, The Netherlands |
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Abstract: | Abstract
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.
Investigation performed at the Department of Traumatology, Maastricht University Hospital, Maastricht, The Netherlands. |
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Keywords: | Soft tissue injuries and infection Fracture care Hip fracture Fractures of the proximal Femur Hip fractures Orthopedic trauma Osteosynthesis |
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