Authors

1María Molero Bastante, 2María Victoria García López, 1Alejandro David Pedraza Cantero, 3María Dolores Pomares Martínez, 3Mercedes Gómez Gómez, 4Laura Moraleda Torres

Position

¹Enfermera interna residente en Geriatría. Complejo Hospitalario de Toledo (CHT).²Enfermera. Profesora titular de la Escuela Universitaria de Castilla La Mancha.³Enfermera, supervisora del Hospital Virgen del Valle (CHT).⁴Enfermera.

Contact address

María Molero Bastante. C/ Veracruz, 12. 13610 Campo de Criptana (Ciudad Real).

Contact email: mmbastante@gmail.com

Abstract

Objective: To learn which frailty indicators are adequate for treatment by nurses in elderly patients who have undergone hip fracture surgery, and how their evolution is.
Method: Descriptive, longitudinal and retrospective study of patients hospitalized in the Hospital Geriátrico Virgen del Valle (HVV), for functional rehabilitation after hip fracture surgery during 2011.
Frailty indicators as described in bibliography were identified, and subsequently patient data were collected through the Nursing Assessment Score (NAS), used as part of the comprehensive evaluation of elderly people; 19 variables were selected as frailty indicators, corresponding to their situation before the fracture, their admission to the Medium Stay Unit (MSU), and at patient discharge.
Results: A sample of 62 patients was obtained, with an average age of 83.2 years. Previous to hip fracture, there were frailty indicators such as mobility disorder (19.4%), cognitive impairment (37.1%) and sensory reduction (51.6%). After the surgical procedure, all indicators increased, particularly dependence for basic everyday activities (BEDAs) and mobility, and an improvement was experienced after staying at the Functional Rehabilitation Unit, but without reaching the values previous to the fracture. The cognitive status of the patient gets worse at discharge, compared with admission at MSU; this affects 66.1% of patients vs. 56.5% at admission and 37.1% previous to fracture.
Conclusion: The information obtained supports the fact that frailty may be at the same time the cause and a consequence of hip fracture. Nursing­ care must be directed to prevent deterioration in mobility disorders, cognitive function, BEDAs, incontinence and pressure ulcers, as these are the frailty predictors more affected after the fracture, and the ones which differ more from the baseline situation after the functional rehabilitation process.

Keywords:

comprehensive geriatric evaluation; elderly; frailty; Geriatric Nursing; Hip fracture; nursing interventionsrehabilitation

Versión en Español

Título:

Relación entre fragilidad y fractura de cadera en el anciano