García-Gollarte Fermín, Ríos Germán Peggy P, Alarcón Teresa, Paz Francisco José, Cuenllas-Díaz Álvaro, González-Montalvo Juan Ignacio
Grupo de Residencias Ballesol.
Servicio de Geriatría, Hospital Universitario La Paz, Madrid, España; Instituto de Investigación, Hospital La Paz (IdiPAZ), Madrid, España.
Rev Esp Geriatr Gerontol. 2020 Jan-Feb;55(1):11-17. doi: 10.1016/j.regg.2019.04.008. Epub 2019 Jul 6.
The aim of this study was to determine the clinical and functional outcomes of patients discharged to nursing homes after a hip fracture.
The study included all patients admitted to a group of nursing homes after a hip fracture in 2016. A geriatric assessment protocol was applied, and patients were treated with a specific protocol for 90 days. They were assessed for nutritional status (Mini-Nutritional Assessment and Body Mass Index), pain (Visual Analogue Scale, and the PAINAD Scale), the presence of pressure ulcers, blood test (D vitamin, haemoglobin, proteins), and functional status (Barthel index and Functional Assessment Categories).
Out of a total of 175 patients, 116 (75%) met the inclusion criteria. The mean age was 84.9 years old (±6.7 SD), and 91 (78.4%) were women. At admission, 73.8% of 65 residents had anaemia, 76.7% hypovitaminosis D, 88% malnutrition or «at risk of malnutrition», and 15.3% had pressure ulcers. After 90 days, the moderate-severe functional status (Barthel index < 60) was reduced from 90.4 to 39.6%, dependence due to gait from 97.3 to 36.1%, and moderate-severe pain from 88.9 to 14.4%. Most of the pressure ulcers healed (94.4%).
Patients admitted to nursing homes after a hip fracture had poor clinical and functional status. This study shows that after 90 days from admission these patients had positive outcomes in terms of functionality, gait, pain control, and pressure ulcers healing.
