Prevention of Pressure Ulcers in Hip Fracture Patients

髋部骨折患者压疮的预防

• 批准号: 6730827
• 负责人: MONA BAUMGARTEN
• 金额: $ 22.28万
• 依托单位: UNIVERSITY OF MARYLAND BALTIMORE
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-09-30 至 2006-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6730827
• 关键词: clinical research; cost effectiveness; decubitus ulcer; disease /disorder prevention /control; health care cost /financing; hip fractures; human old age (65+); human subject; interview; patient oriented research

DESCRIPTION (provided by applicant): Pressure ulcers constitute an important clinical problem, both in terms of patient suffering and cost of care. The elderly patient undergoing hip surgery is at high risk for pressure ulcers by virtue of exposure to long periods of immobility before, during, and after surgery, and by virtue of exposure to friction and shearing injuries when being transferred to and from beds, stretchers, x-ray tables, and operating tables. Epidemiologic studies have established that the incidence of pressure ulcers in hip fracture patients is high. National panels have identified hip fracture patients as a high-risk group and have emphasized the urgent need for rigorous evaluations of promising preventive interventions in this patient population. We propose to evaluate a comprehensive intervention for the prevention of pressure ulcers in hip fracture patients. The intervention will involve the provision of pressure-reducing devices during the emergency department stay, in the operating room, and during the pre- and postoperative periods. The devices that are evaluated will relieve pressure both on the sacral area and the heels, will be for use on stretchers, beds, and chairs, and will be inexpensive and easy to use and maintain. The intervention will be evaluated using a rigorous randomized controlled trial (RCT) design. The primary aim of this RCT (which we will refer to as the "future trial") will be to determine whether the incidence of pressure ulcers is lower among hip fracture patients randomized to the preventive intervention than in patients randomized to usual care. Secondary aims will be to estimate the incremental cost-effectiveness of the intervention and to compare patients in the intervention and control groups with respect to patient-assessed comfort while lying and while seated. In the present application, we are requesting support for the planning and development of the future trial. The planning process will involve the analysis of existing data, the conduct of preliminary studies, and the development of detailed research protocols for the trial. At the end of the planning project, we will be poised to submit a proposal that applies rigorous research methods to an important clinical problem.

描述（由申请人提供）：在患者痛苦和护理成本方面，压力溃疡构成了一个重要的临床问题。接受髋关节手术的老年患者由于在手术前，期间和手术后长期侵害不动，并且由于暴露于摩擦和剪切受伤时，由于暴露于长时间的不动性，因此处于高炎症和剪切伤害时，处于高风险状态。流行病学研究表明，髋部骨折患者的压疮的发生率很高。国家小组已将髋部骨折患者确定为一个高风险组，并强调迫切需要严格评估该患者人群的预防干预措施。我们建议评估用于预防髋部骨折患者压力溃疡的全面干预措施。干预措施将涉及在急诊室住宿，手术室以及术前和术后期间提供减压设备。评估的设备将减轻s骨区域和高跟鞋的压力，可用于担架，床和椅子，并且将廉价且易于使用和维护。将使用严格的随机对照试验（RCT）设计评估干预措施。该RCT的主要目的（我们将称为“未来试验”）是确定随机与预防性干预的髋部骨折患者的压力溃疡的发生率是否低于随机治疗常规护理的患者。次要目的是估计干预措施的增量成本效益，并在撒谎和坐下时在干预组和对照组中的患者进行比较。在本申请中，我们要求支持未来审判的计划和开发。计划过程将涉及现有数据的分析，初步研究的进行以及为试验的详细研究方案的制定。在计划项目结束时，我们将准备提交一项建议，将严格的研究方法应用于重要的临床问题。