Pressure Ulcers Research Articles

Evaluation of home health services provided to children in Batman province

Aims: To evaluate the home health services provided to children in Batman, a province in the Southeastern Anatolia Region of Turkiye, where the birth rate and consanguineous marriages are high. Methods: For this descriptive and cross-sectional study, data from 460 patients aged 0-18 years who received services from the Home Health Unit of Batman Training and Research Hospital between January 10, 2018, and January 10, 2023, were retrospectively scanned through the Hospital Information Management System. Results: 57.6% of the patients were male and 42.4% were female. The mean age of the patients was 10.64±4.5 years; the proportion of patients aged 0-6 years was 20%, 7-12 years was 41.1%, and 13-18 years was 38.9%. Mental retardation was observed in 15%, cerebral palsy in 42.8%, hydrocephalus in 7.8%, epilepsy in 17%, spina bifida/meningocele/meningomyelocele in 4.1%, neuromuscular and motor disorders (paresis/plegia, etc.) in 10.4%, and osteogenesis imperfecta in 3%. While 99.6% of reasons for physician visits were non-emergency, the most common reason for visits by non-physician health personnel was dressing and monitoring of fever, pulse, and blood pressure, at 94.8%. The proportion of patients in need of nursing services was 98.7%; the proportion of patients with pressure sore signs was 87.8%; and the proportion of fully dependent patients was 93.9%. Conclusion: To provide home health services more effectively and efficiently, it is necessary to increase social awareness, improve health literacy to eliminate regional differences, and expand telehealth applications. For better quality service delivery, it is of vital importance to provide periodic training to those engaged in patient care, especially on managing bed sores. In this way, home health services for children can become more accessible and effective.

Current situation of knowledge, practice skill of nurses on wound care and some related factors according to Vietnamese nursing competency standards: A study in a hospital in Hanoi

Background: The introduction of Vietnamese Nursing Competency Standards in 2012 has urged the needs for re-assessment of nursing skills, with the aim to improve the quality of the training on wound care in country. Purposes: The study aimed to describe knowledge and practice of nurses on wound care and identify some the related factors in order to make the recommendation for improvement of the nursing care competency. Methods: This a cross-sectional descriptive prospective study was conducted in Ha Dong General Hospital from July 2023 to October 2023. Results: 76 clinical nurses were enrolled with the mean age was 35.6±6.8 years, female nurses most commonly accounted for 89.5%. Notably, the lowest average score in terms of knowledge was observed in suture removal (9.74±3.21) and pressure ulcer wound care (6.93±1.63). In terms of practice, the lowest average score was recorded for pain assessment and bleeding control (7.91±1.33). Furthermore, the study revealed a statistically significant correlation between knowledge and working experience (p<0.05). Nurses with a good level of knowledge were found to have a 4.66 times higher likelihood of demonstrating good practice (OR=4.66). Conclusions and recommendations: The factors related to the competency of wound care of nurses were found in the study strongly suggest the need for improvement of quality of training in order to align with the established standards.

Estimation of extreme wind pressure coefficients of buildings using POT with automated threshold selection

Extreme wind pressure coefficients of the high-rise buildings are critical for determining wind loads on components and claddings. To address the issue of insufficient samples in the widely used block maximum (BM) method, the peak over threshold (POT) method has been introduced in wind engineering for more effective and accurate estimation of extreme wind pressure coefficients. However, it is quite a challenge to appropriately select the threshold. This study proposes an automated threshold selection procedure using L-moment theory. Monte Carlo simulation is conducted to substantiate the theoretical feasibility of this procedure. Utilizing data from wind-tunnel pressure measurements of a high-rise building model, the study automatically selects thresholds and estimates extreme wind pressure coefficients. Comparative analysis with the BM method demonstrates that thresholds determined through automated threshold selection procedure exhibit stability with minimal deviation from standard extreme values. Furthermore, the developed procedure can effectively adapt to non-Gaussian characteristics of the sample time histories.

Evaluation of the risk prediction model of pressure injuries in hospitalized patient: A systematic review and meta-analysis.

The main aim of this study is to synthesize the prevalent predictive models for pressure injuries in hospitalized patients, with the goal of identifying common predictive factors linked to pressure injuries in hospitalized patients. This endeavour holds the potential to provide clinical nurses with a valuable reference for providing targeted care to high-risk patients. Pressure injuries (PIs) are a frequently occurring health problem throughout the world. There are mounting studies about risk prediction model of PIs reported and published. However, the prediction performance of the models is still unclear. Systematic review and meta-analysis: The Cochrane Library, PubMed, Embase, CINAHL, Web of Science and Chinese databases including CNKI (China National Knowledge Infrastructure), Wanfang Database, Weipu Database and CBM (China Biology Medicine). This systematic review was conducted following PRISMA recommendations. The databases of Cochrane Library, PubMed, Embase, CINAHL, Web of Science, and CNKI, Weipu Database, Wanfang Database and CBM were searched for all studies published before September 2023. We included studies with cohort, case-control designs, reporting the development of risk model and have been validated externally and internally among the hospitalized patients. Two researchers selected the retrieved studies according to the inclusion and exclusion criteria, and critically evaluated the quality of studies based on the CHARMS checklist. The PRISMA guideline was used to report the systematic review and meta-analysis. Sixty-two studies were included, which contained 99 pressure injuries risk prediction models. The AUC (area under ROC curve) of modelling in 32 prediction models were reported ranged from .70 to .99, while the AUC of verification in 38 models were reported ranged from .70 to .98. Gender (OR = 1.41, CI: .99 ~ 1.31), age (WMD = 8.81, CI: 8.11 ~ 9.57), diabetes mellitus (OR = 1.64, CI: 1.36 ~ 1.99), mechanical ventilation (OR = 2.71, CI: 2.05 ~ 3.57), length of hospital stay (WMD = 7.65, CI: 7.24 ~ 8.05) were the most common predictors of pressure injuries. Studies of PIs risk prediction model in hospitalized patients had high research quality, and the risk prediction models also had good predictive performance. However, some of the included studies lacked of internal or external validation in modelling, which affected the stability and extendibility. The aged, male patient in ICU, albumin, haematocrit, low haemoglobin level, diabetes, mechanical ventilation and length of stay in hospital were high-risk factors for pressure injuries in hospitalized patients. In the future, it is recommended that clinical nurses, in practice, select predictive models with better performance to identify high-risk patients based on the actual situation and provide care targeting the high-risk factors to prevent the occurrence of diseases. The risk prediction model is an effective tool for identifying patients at the risk of developing PIs. With the help of risk prediction tool, nurses can identify the high-risk patients and common predictive factors, predict the probability of developing PIs, then provide specific preventive measures to improve the outcomes of these patients. CRD42023445258.

Comparison of the Effectiveness Lateral Position 30 Degrees and 90 Degrees on Decubitus Events in Stroke Patients

Aims: Stroke is the second leading cause of death and disability globally, characterized by sudden neurological deficits. Pressure ulcers, caused by prolonged bed rest, can be managed non-pharmacologically through immobilization and routine tilting to prevent decubitus. To compare the effectiveness of the lateral position with an inclination of 30 and 90 degrees on the risk of decubitus in stroke patients, in this study the control group was tilted 90 degrees and the intervention group was tilted 30 degrees. Method: The sampling method is non-probability sampling with purposive sampling, a sample of 22 patients. Results: Data analysis using Reapeted Measurement Anova resulted in a value in the experimental group resulting in a sum of square value of 24.9, f value 14.3, P < 0.001, while in the control group a sum of square value of 76.5, f value 26.8, P < 0.001 was obtained, so it can be concluded that the lateral position with an inclination of 90 degrees and 30 degrees has the same effect, namely providing a significant influence on reducing the risk of decubitus. Conclusions: The study reveals that stroke patients aged 56-65 have a higher risk of pressure ulcers, with low-weight patients at higher risk. Early lateral position intervention and nutrition can significantly reduce the risk of decubitus, highlighting the importance of early wound healing.

Interference effect on super large twin cooling towers exposed to stationary tornado-like vortices

A comprehensive investigation was conducted aiming at the interference effects on wind pressure distribution, aerodynamics characteristics, structural stability and reinforcement areas of super large twin cooling towers exposed to tornado-like vortices, and the effects of swirl ratios of tornados, grouped tower layouts, and relative central distances between the towers and the tornado were analysed based on a tornado-like vortex simulator. Two types of rigid model wind tunnel experiments were constructed for base forces and wind pressure distribution measurements. The experimental results demonstrate that the interference effects on base forces and local wind pressures are significantly influenced by the swirl ratios, central distances, and grouped tower layouts, etc. Moreover, the layout with a tornado located on the side of tandem twin cooling towers (along with the tornado translation direction being perpendicular to the central axis of the tandem combined twin cooling towers) is the most unfavourable, resulting in obvious amplification effects on base forces and local wind pressures compared with an isolated tower, and the maximum of interference factors (IFs) is 1.68 and 1.41 for the along-wind total wind force coefficient and minimal net mean pressure coefficient respectively. Subsequently, local stability indices and time-variant dynamic reinforcement envelopes were selected as the other evaluation criteria for estimating the interference effects on the cooling towers exposed to the tornado-like vortices, and the interference effects result in enlargements of the structural responses with the maximal IF of 1.36 for the inside meridional reinforcement. Finally, the various interference criteria at aerodynamic loading and structural reinforcement aspects were contrastive analysed, showing that the criterion of time-variant dynamic reinforcement area envelopes is a more reasonable criterion for evaluating the interference effects on the super large cooling towers exposed to the tornado-like vortices. This investigation aims to contribute to a better understanding of the wind-related effects of the cooling towers exposed to extreme non-synoptic winds, particularly tornadic vortex impacts.

Application of nursing interventions based on a multidisciplinary team in wound care for patients with pressure injuries

Application of nursing interventions based on a multidisciplinary team in wound care for patients with pressure injuries

Prevalence of pressure ulcers and associated factors among adult patients admitted at Comprehensive Specialized Hospital, Northwest Ethiopia, 2023

Pressure ulcers are a serious concern in patients with prolonged bedtime and present with common complications following surgery. It is one of the key performance indicators of the quality of nursing care provided to patients. Several studies have reported the prevalence of pressure ulcers in Ethiopia, but the current study area has not yet been fully addressed. Hence, the study aims to assess pressure ulcers and their associated factors among adult patients admitted to the surgical ward. An institution-based, cross-sectional study was conducted from April 15 to May 15, 2023. A systematic random sampling technique was used to select 480 patients. A standardized, pre-tested, and structured questionnaire was used. The results were presented descriptively using tables and figures. A binary logistic regression was used to assess associated factors. From a total of 480, all patients have participated with a 100% response rate. The prevalence rate of pressure ulcers was 10.2%. Being smoker [95% CI AOR 7.46 (2.64, 21.06)], bedridden [95% CI AOR 3.92 (1.28, 11.66)], having a length of hospital stay of greater than 20 days [95% CI AOR 3.01 (1.13, 8.02)], experiencing pain [95% CI AOR 3.20 (1.06, 7.51)], or having friction and shear [95% CI AOR 5.71 (1.91, 17.08)], were significantly associated with pressure ulcers. This study showed that a considerable proportion of patients had pressure ulcers. Smoking, having pain, being bedridden, being exposed to friction and shear problems, and length of hospital stay were significantly associated with pressure ulcers. Healthcare providers should educate patients about smoking risks, pain management, mattress installation, and linen care

Exposure to volatile ferroptosis inhibitor, TEMPO, reduced cutaneous ischemia-reperfusion injury progression to pressure ulcer formation in a mouse model

BackgroundIschemia– reperfusion (I/R) injury-induced oxidative stress is a key factor in the pathogenesis of pressure ulcer formation. Ferroptosis is an iron-dependent programmed cell death that connects oxidative stress and inflammation in various diseases. Recent studies revealed the protective effect of inhibition of ferroptosis in I/R injury. However, the role of ferroptosis in cutaneous I/R injury remains elusive. ObjectiveTo assess the role of ferroptosis in the progression of cutaneous I/R injury. MethodsCutaneous I/R injury experiments and histopathological studies were performed in wild-type mice with or without exposure to volatile ferroptosis inhibitor, TEMPO (2,2,6,6-Tetramethylpiperidine-1-oxyl). The suppressive effects of TEMPO on ferroptosis inducing cell death and oxidative stress were examined in vitro. ResultsInhibition of ferroptosis with TEMPO significantly reduced ulcer formation after cutaneous I/R injury. Fluctuated ferroptosis markers, such as GPX4, ACSL4, and 4-HNE expression in the I/R skin site, were reversed by TEMPO treatment. Inhibition of ferroptosis reduced apoptosis, CD3+ infiltrating lymphocytes, and improved vascularity in the I/R skin site. Inhibition of ferroptosis also suppressed the enhancement of Nrf2 activation. In vitro, ferroptosis and the activation of ferroptosis-related gene expression by RSL3 stimulation were markedly ameliorated by TEMPO treatment in mouse fibroblasts. Inhibiting ferroptosis also suppressed the elevation of the mRNA levels of NOX2 and HO-1 caused by ferroptosis. ConclusionCutaneous I/R injury-induced ferroptosis likely promotes cell death, vascular loss, infiltration of inflammatory cells, and oxidative stress. The inhibition of ferroptosis with TEMPO might have potential clinical application as novel therapeutic agent for cutaneous I/R injury.

Risk factors for pressure injuries in individuals with spinal cord injuries who have sarcopenic obesity: A comparison of time-dependent changes in sacral region pressure between individuals with and without sarcopenic obesity

Objective To identify the risk factors for pressure injuries in individuals with spinal cord injuries (SCIs) who have sarcopenic obesity, comparing time-dependent changes in sacral region pressure in individuals with and without sarcopenic obesity. Design An experimental time series study. Setting Single-center hospital. Participants Twenty-five adult participants with subacute and chronic paraplegia who visited our rehabilitation center, Republic of Korea, between May 2021 and June 2022. Interventions Whole-body dual-energy X-ray absorptiometry was performed to diagnose sarcopenic obesity. After the participants were placed in the supine position for 1 hour, the average pressure (mmHg), peak pressure (mmHg), and total contact area (cm2) of the sacral region were measured using the pressure-mapping system. Results Compared with the non-sarcopenic obesity group, the sarcopenic obesity group showed significant before-and-after differences in peak pressure. Furthermore, the risk factors that were significantly associated with peak pressure in the sarcopenic obesity group were the American Spinal Injury Association Impairment Scale score and the fat mass index. Conclusion Among participants with SCIs, the risk of pressure injuries is higher in the sarcopenic obesity group than in the non-sarcopenic obesity group. Notably, the risk of pressure injuries increases in participants who have complete injury and an increased fat mass index, indicating the importance of close monitoring and more active management to prevent pressure injuries in this subpopulation.

The effect of an educational intervention on perioperative registered nurse's knowledge, attitudes, and behaviors towards pressure injury prevention in surgical patients

BackgroundPressure injuries continue to be a significant problem in perioperative patients. Surgical patients are particularly at risk due to lack of mobility and sensation during surgery and the early recovery period. The AORN (2024) recommends that healthcare organizations develop a comprehensive prevention program that includes risk assessment, prevention, and education. ObjectivesTo measure the effect of an educational intervention on perioperative nurses' knowledge, attitudes, and behaviors towards pressure injury prevention after one week and again after six months. MethodsNurse's knowledge, attitudes, and behaviors were measured at three different time periods using quantitative nonexperimental pretest posttest longitudinal design. Three hundred fifty-four perioperative registered nurses from 11 acute care hospitals participated. ResultsNurses' knowledge scores were in the moderate range. Statistically significant differences were found between pre-test and posttest 1 scores, indicating that knowledge improved after nurses completed the education intervention and information was retained six months after. Nurses' attitudes were neither positive nor negative towards pressure injury prevention. Regarding behavior, the majority of nurses reported carrying out pressure injury prevention strategies, however only half reported carrying out daily risk assessment strategies. ConclusionsTo prevent pressure injury in perioperative patients, it is imperative that guidelines for the prevention of perioperative pressure injury (AORN, 2024) are integrated into nursing practice.

Platelet-rich plasma and plasma rich in growth factors in extra-oral wound care.

This narrative review evaluates the existing literature on the clinical efficacy and safety of platelet-rich plasma (PRP) and plasma rich in growth factors (PRGFs) in extra-oral wound care, considering their potential benefits and drawbacks. The review specifically focuses on the impact of these treatments on patients' quality of life, pain management, treatment costs, recurrence rates, and potential complications. Given the extensive literature and diverse range of extra-oral wound types in which these autologous platelet concentrates have been applied, this narrative review focuses on the most frequently described wound types, including diabetic foot ulcers, venous leg ulcers, pressure ulcers, surgical wounds, and burns. The use of PRP has been reported in various medical specialties, with a low risk of adverse events. While there is a growing interest in the use of PRGF with promising results, the available literature on this topic is still limited. Only a few studies evaluated patients' perception of the treatment and the relationship between treatment costs and clinical outcomes. Data on recurrence rates and complications also vary across studies. In conclusion, PRP and PRGF show promise as alternatives or as adjunctive therapies to conventional treatments for various extra-oral wounds and ulcers, leading to reduced wound size and accelerated healing time but should be considered on a case-by-case basis, taking into account the type and severity of the wound.

Pediatric pressure injuries: A systematic review of interventions to prevent hospital-acquired pressure injuries in the pediatric population

Pediatric pressure injuries: A systematic review of interventions to prevent hospital-acquired pressure injuries in the pediatric population

Solar Cycle Influence on Wind, Temperature, and Surface Pressure During 1981–2021 Over Indian Region

Solar Cycle Influence on Wind, Temperature, and Surface Pressure During 1981–2021 Over Indian Region

Extracranial Complications in Monitored and Nonmonitored Patients with Traumatic Brain Injury in the BEST TRIP Trial and a Companion Observational Cohort

Extracranial complications occur commonly in patients with traumatic brain injury (TBI) and can have implications for patient outcome. Patient-specific risk factors for developing these complications are not well studied, particularly in low and middle-income countries (LMIC). The study objective was to determine patient-specific risk factors for development of extracranial complications in TBI. We assessed the relationship between patient demographic and injury factors and incidence of extracranial complications using data collected September 2008-October 2011 from the BEST TRIP trial, a randomized controlled trial assessing TBI management protocolized on intracranial pressure (ICP) monitoring versus imaging and clinical exam, and a companion observational patient cohort. Extracranial infections (55%), respiratory complications (19%), hyponatremia (27%), hypernatremia (27%), hospital acquired pressure ulcers (6%), coagulopathy (9%), cardiac arrest (10%), and shock (5%) occurred at a rate of ≥5% in our study population; overall combined rate of these complications was 82.3%. Tracheostomy in the intensive care unit (P < 0.001), tracheostomy timing (P= 0.025), mannitol and hypertonic saline doses (P < 0.001), brain-specific therapy days and brain-specific therapy intensity (P < 0.001), extracranial surgery (P < 0.001), and neuroworsening with pupil asymmetry (P= 0.038) were all significantly related to the development of one of these complications by univariable analysis. Multivariable analysis revealed ICP monitor use and brain-specific therapy intensity to be the most common factors associated with individual complications. Extracranial complications are common following TBI. ICP monitoring and treatment are related to extra-cranial complications. This supports the need for reassessing the risk-benefit balance of our current management approaches in the interest of improving outcome.

Prevention of ear‐looped face mask‐induced pressure injury on ears: A Technical report with review of literature

In modern times, protective masks with flexible loops are commonly used to prevent the spread of microorganisms during surgical procedure the constant contact of the stretching bands caused by wearing a mask for several hours’ daily causes pressure on this cartilage, leading to painful and erythematous lesions on the skin behind the auricles. Patients and the public now wear masks for extended periods of time. Over time, wearing this mask frequently can cause damage to the ear. Consequently, people regularly switch out their masks to alleviate pressure, increasing their chances of getting infected. Doctors and other healthcare professionals should be aware that continued use may cause damage to the ears and auricles. This article addresses a novel method to alleviate stress on the ear loops of surgical masks and examines the typical ear injuries or pressure injuries on the ear mentioned in literature regarding prolonged mask usage and ways to prevent them.Keywords: Pressure injury; Ear injury; Pinna injury; Surgical masks; Elastic ear loops

The incidence and risk factors for unplanned readmission within 90 days after surgical treatment of spinal fractures.

Unplanned readmissions after spine surgery are undesired, and cause significant functional, and financial distress to the patients and healthcare system. Though critical, knowledge about readmissions after surgery for traumatic spinal injuries (TSI) is scarce and under-evaluated. Consecutive patients surgically treated for TSI and who had unplanned readmission within 90 days post-discharge were studied. Peri-operative demographic and surgical variables, surgical treatment, level of injury, delay in surgery, ASIA score, other organ injuries, peri-operative complications, smoking, ICU stay, co-morbidity, and the length of hospital stay were studied and correlated with the causes for readmission. Among 884 patients, 4.98% (n = 44) had unplanned readmissions within 90 days of discharge. Notably, 50% (n = 22) patients were readmitted within the first 30 days. The common causes of readmissions were urinary tract related problems (27%, n = 12), pressure ulcers (20.4%, n = 9), respiratory problems (13.6%, n = 6), surgical wound related problems (14%, n = 7,) limb injuries (11.4%, n = 5), and others (11%, n = 5). The total beds lost secondary to readmissions was 314 days, and the mean bed-days lost per patient was 7.2 ± 5.1. Thirteen peri-operative risk factors were associated with unplanned readmissions, among which, smoking (OR 2.2), diabetes (OR 2.4), and pressure sore during index admission (OR 16.7) were strong independent predictors. The incidence of unplanned readmissions after TSI was 5%, which was similar to elective spine surgeries but the causes and risk factors are different. Non-surgical complications related to urinary tract, respiratory care and pressure sores were the most common causes. Pre-operative smoking status, diabetes mellitus and pressure sores noted in the index admission were important independent risk factors.

Why do pressure injuries still occur? A multicenter qualitative study of nurses and caregivers

BackgroundThe frequent occurrence of pressure injuries despite their preventability, raises important questions about our understanding of the barriers to care. This study explores the lived experience of nurses and caregivers in Singapore to establish a conceptual framework for better understanding pressure injuries arising in the community. MethodsA multicentre qualitative study was conducted utilising semi-structured interviews and focused group discussions of nurses and caregivers of patients with pressure injuries. Data was collected with a narrative inquiry approach and analysed with grounded theory. An iterative cycle of interviewing, coding, discussion and reflection was conducted until theoretical saturation. ResultsTen inpatient nurses and ten caregivers from the community were recruited. Analysis identified cognitive (awareness and caregiver training), emotional (motivation and empowerment), resource (human and infrastructural), and biomedical factors which collectively impacted the effectiveness of prevention. Additionally, constructs of learning and sustainability of caregiving played a crucial role in long term prevention. LimitationThe derived framework requires further validation with quantitative data and may not be generalizable to other cultural and economic populations. ConclusionMultiple constructs have been identified to have a synergistic effect in prevention. Targeted measures should be implemented by healthcare institutions to better equip caregivers in prevention.

Spatial distribution of patients with pressure injuries treated at a teaching hospital

Introduction: Pressure injury (PI) is characterized by pressure exerted mainly on bony prominences, or even related to the use of medical devices. As epidemiological aspects are still scarce in the country, it is appropriate to produce studies that delimit the information for a better characterization of this public health problem, with extraterritorial dimensions. Geoprocessing is a revolutionary technology that encompasses the most diverse disciplines, data, equipment, analysis and interpretations from certain locations and geographic data, thus obtaining maps and/or spreadsheets with information relevant to that particular region that, when used in the health area, allows the identification and mapping of risks and injuries that affect the population. Objective: To demonstrate the technical experience of spatial demarcation and geoprocessing of patients with pressure injuries treated at a teaching hospital in the state of Sergipe. Method: A descriptive epidemiological study was carried out from a data sheet of patients with pressure injuries treated by the Skin Care Service team of a teaching hospital in Sergipe, between 2018 and 2022. Georeferencing and geoprocessing were developed in conjunction with Google Maps and Google Earth software. Results: The study sample consisted of 215 patients with pressure injuries (PI) in which the age group that stood out was the elderly (54.8%), followed by adults (40.0%). It is noted, in the spatial representation, that most of the patients with PL were residents of Greater Aracaju (n=130), followed by the East of Sergipe (n=23) and Central Agreste (n=18). Most of the LPs were acquired prior to admission to the institution studied (55.8%), while the others (44.2%) appeared during the hospital stay. Conclusion: In view of the analysis presented, it was possible to verify that most patients affected by PLs are men and elderly, and that the Greater Aracaju regional was the one that stood out the most because it concentrated most of the patients with PL, whether pre-existing or acquired at hospitalization.

DOES PRE-HOSPITAL DELAY AFFECT OUTCOMES IN HIP FRACTURE PATIENTS?

BackgroundHip fractures cost the NHS £2 billion per annum. British guidelines within 36 hours of admission. However, these guidelines do not consider the time the patient spends between injury and admission. Our study aims to investigate pre-hospital time (PHT) and its effect on outcomes. Primary outcome measures were mortality, length of stay (LOS), pressure sores and abbreviated mental test scores (AMTS).MethodsHip fracture data was retrospectively collected from our hospital IT system (Clinical Workstation) between February and August 2020. Admission data, ambulance timings, and outcome data was extracted. Statistical analysis was performed using GraphPad Prism V9.5.1.ResultsTwo hundred eleven data sets were analysed. Mean age was 82.4, with 2:1 Females to males and median ASA of 3. The mean PHT was 690 minutes (85 to 6057). There was a positive correlation between increased PHT and mortality, though this did not reach statistical significance. There was a significant positive association between PHT and LOS (P=0.0027). Increased PHT was associated with lower admission AMTS (P&lt;0.0001) and higher rate of pressure sore formation (P=0.0001). There was also a significantly positive correlation between PHT and time to mobility (P=0.049).ConclusionThere is an unobserved delay in hip fracture patients presenting to the hospital. Current treatment guidelines advocate early surgery but do not consider pre-hospital time. PHT in our patient population is 690 minutes on average, with increasing delay correlating with worse outcomes. Pre-hospital time should be considered when managing hip fracture patients with a view to expedite surgery and medical assessment.