Predictive factors for category II pressure ulcers in older patients with hip fractures: a prospective study

Domenica Gazineo, Paolo Chiari, Matteo Chiarabelli, Mattia Morri, Fabio D'Alessandro, Tania Sabattini, Elisa Ambrosi, Cristiana Forni

Research output: Contribution to journalArticlepeer-review


OBJECTIVE: To identify the incidence of category II or higher hospital-acquired pressure ulcers (HAPU) and significantly associated factors in older patients with hip fractures. PUs are a frequent complication in hip fracture patients, negatively impacting patients' quality of life, the health-care system and society.

METHOD: A prospective cohort study was conducted. A consecutive sample of patients with pertrochanteric, femoral neck or subtrochanteric fractures requiring surgical treatment, were included. A stepwise, multiple regression was performed to identify factors associated with PU development.

RESULTS: A total of 761 patients aged ≥65 years were sampled. The incidence of category II or higher PUs was 12%. The study identified five factors that were significantly, independently associated with category II or higher PU development, including a higher preoperative Braden score (Hazard Ratio [HR]: 0.884; 95% confidence interval [CI]: 0.806-0.969), surgical procedure with osteosynthesis (HR 1.876; 95%CI: 1.183-2.975), a higher percentage of days with the presence of foam valve before surgery (HR: 1.010; 95%CI: 1.010-1.023) and a urinary catheter (HR: 1.013; 95%CI: 1.006-1.019) and diaper (HR: 1.007; 95% CI 1.001-1.013) in the postoperative period.

CONCLUSION: Attention should be given by clinical staff to avoiding the use of foam valves, to limiting the use of diapers and to early removal of urinary catheters.

Original languageEnglish
Pages (from-to)593-599
Number of pages7
JournalJournal of wound care
Issue number9
Publication statusPublished - Sep 2 2019


  • hip fractures
  • older people
  • pressure ulcers
  • prospective study
  • risk factors


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