Cognitive function and pressure ulcers in hip fracture patients

The primary aim of this study was to analyse the documented frequency of pressure ulcers in relation to the patients' cognitive status during the acute care after a hip fracture. The secondary aim was to investigate to what extent the information about pressure ulcers is passed on to the next caregiver. The patient population consisted of 356 patients being admitted to hospital because of a hip fracture. The patients' cognitive function was assessed with the Short Portable Mental Status Questionnaire. The outcome for patients with severe cognitive dysfunction was compared with the outcome for those without severe cognitive dysfunction. The overall incidence of pressure ulcers was 16%. Twenty-three percent of the patients with severe cognitive dysfunction developed a pressure ulcer during hospitalization compared with 14% of patients without severe cognitive dysfunction (p < 0.05). Although patients with severe cognitive dysfunction had an increased risk of developing pressure ulcers, the severity and the localization of their ulcers were comparable to those without severe cognitive dysfunction. Information regarding the presence of the pressure ulcers in the nurses' report to the next caregiver was lacking for 42% of the patients with ulcers regardless of the cognitive function status. In summary, the incidence of pressure ulcers was increased in hip fracture patients with severe cognitive dysfunction. In the acute setting in routine health care, the caregiver needs a validated and feasible instrument for assessing the patient's cognitive function as well as robust criteria for identifying patients at risk for developing pressure ulcers.