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Pressure-redistributing support surface use and pressure ulcer incidence in elderly hip fracture patients.

Abstract：

OBJECTIVES:To evaluate the association between pressure-redistributing support surface (PRSS) use and incident pressure ulcers in older adults with hip fracture. DESIGN:Secondary analysis of data from prospective cohort with assessments performed as soon as possible after hospital admission and on alternating days for 21 days. SETTING:Nine hospitals in the Baltimore Hip Studies network and 105 postacute facilities to which participants were discharged. PARTICIPANTS:Six hundred fifty-eight people aged 65 and older who underwent surgery for hip fracture. MEASUREMENTS:Full-body examination for pressure ulcers; bedbound status; and PRSS use, recorded as none, powered (alternating pressure mattresses, low-air-loss mattresses, and alternating pressure overlays), or nonpowered (high-density foam, static air, or gel-filled mattresses or pressure-redistributing overlays except for alternating pressure overlays). RESULTS:Incident pressure ulcers (IPUs), Stage 2 or higher, were observed at 4.2% (195/4,638) of visits after no PRSS use, 4.5% (28/623) of visits after powered PRSS use, and 3.6% (54/1,496) of visits after nonpowered PRSS use. The rate of IPU per person-day of follow-up did not differ significantly between participants using powered PRSSs and those not using PRSSs. The rate also did not differ significantly between participants using nonpowered PRSSs and those not using PRSSs, except in the subset of bedbound participants (incidence rate ratio=0.3, 95% confidence interval=0.1-0.7). CONCLUSION:PRSS use was not associated with a lower IPU rate. Clinical guidelines may need revision for the limited effect of PRSS use, and it may be appropriate to target PRSS use to bedbound patients at risk of pressure ulcers.

journal_name

J Am Geriatr Soc

journal_title

Journal of the American Geriatrics Society

authors

Rich SE,Shardell M,Hawkes WG,Margolis DJ,Amr S,Miller R,Baumgarten M

doi

10.1111/j.1532-5415.2011.03446.x

subject

Has Abstract

pub_date

2011-06-01 00:00:00

pages

1052-9

issue

6

eissn

0002-8614

issn

1532-5415

journal_volume

59

pub_type

杂志文章

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