Delayed Hospital Discharges; Could Pressure Sore Incidents in Fractured Neck of Femurs Patients and Elevated Nutritional Needs be a Contributing Factor?

Abstract

Background Development of pressure ulcer (PU) during hospital admission causes morbidity and distress to the patient, places immense strain on nursing resources and delaying patient#x2019;s discharge and possibly increasing mortality rates. Fracture neck of femur(NOF) in the elderly population is recognised as a high-risk factor for development of PU. Aims:The aim of this retrospective observational study was to analyse data to assess prevalence rates of PU development in NOF patients during hospital admission amongst the elderly population. Methods: The data was collected from the National Hip Fracture Database (NHFD) on patients admitted with NOF between 1st April 2015 #x2013; 30th September 2015 in a Trauma and Orthopaedic Regional Centre Research Unit. East Sussex Hospital Trust. Results: 258 patients with NOFwere included in this study, predominantly females. NOF patients with PU were older and had prolonged average length of stay compared to patients with NOF without PU respectively (25.3 days Vs 19.2 days). Average body mass index (BMI) in NOF patients with PU was higher compared to patients with NOF without PU (24.45kg/m2 vs. 23.4kg/m2 respectively, P = 0.038). This study showed an increased incidence rate of PU in the higher age group and those with higher BMI. Conclusions: Patients with NOF are at higher risk of malnutrition during hospital admission secondary to elevated nutritional requirements for wound healing and recovery. Therefore, authors recommend that all individuals are nutritionally screened on admission using a validated tool and commenced on appropriate nutritional support plan devised by specialist dietetic team