Potentially modifiable post-fracture complications, including
pneumonia and pressure ulcers (pressure sores, bed sores, decubitus ulcers), are associated with an increased risk of
death among nursing home residents who have suffered a hip fracture,
according to a new study conducted by scientists at the Institute for
Aging Research at Hebrew SeniorLife.
“Prevention strategies to
reduce pressure ulcers and pneumonia may help reduce mortality in this
frail population,” says the lead author who is a
research fellow at the Institute and a staff geriatrician at Hebrew
Rehabilitation Center.
Published online by the Journal of Gerontology: Medical Sciences,
the study found that pneumonia and pressure ulcers, also called bed
sores, contributed to a 70 percent increase in mortality within six
months of a hip fracture among nursing home residents. Compared to
other studies, says Dr. Berry, “we found an even greater prevalence of
the post-fracture complications of pneumonia and pressure ulcer, which
is likely a reflection of our frail, institutionalized population.”
The
study followed 195 long-term care residents with a hip fracture from
1999 to 2006, measuring pre-fracture characteristics such as age, sex,
cognition and functional status; hospital complications such as heart
attack and congestive heart failure; and six-month complications,
including delirium, pneumonia and urinary tract infection. Consistent
with studies of community dwellers, the Institute for Aging Research
investigators found that male nursing home residents with a hip
fracture were more likely to die than female residents with a hip
fracture. The prevalence of delirium, an acute confusional state, in
men after hip fracture may be responsible, at least in part, for the
marked gender difference in survival. Fifty-four percent of male
nursing home residents died within a year of their hip fracture,
compared to 36 percent of female residents. Nationwide, about one of
five hip fracture patients dies within a year of their injury,
according to the Centers for Disease Control and Prevention.
Little
is known about complications that occur after hospitalization for a hip
fracture, particularly in the nursing home setting. Previous studies
have found, however, a high prevalence of pneumonia and pressure ulcer
development among hospitalized elders with a hip fracture.
“These
findings are important given that marked variations in the incidence of
both pneumonia and pressure ulcers exist between nursing home
facilities, suggesting that these complications may be modifiable,” the
researchers write. For more, read the story.
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Robert W. Carter, Jr. is a Virginia attorney whose law practice is
dedicated to protecting the rights of the victims of nursing
home and assisted living neglect and abuse in Richmond, Roanoke,
Norfolk, Lynchburg, Danville, Charlottesville, and across Virginia.
