{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T20:43:35Z","timestamp":1770497015626,"version":"3.49.0"},"reference-count":47,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T00:00:00Z","timestamp":1686268800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Geriatric trauma patients represent a special challenge in postoperative care and are prone to specific complications. The goal of this study was to analyse the predictive potential of a novel nursing assessment tool, the outcome-oriented nursing assessment for acute care (ePA-AC), in geriatric trauma patients with proximal femur fractures (PFF).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A retrospective cohort study of geriatric trauma patients aged \u2265 70 years with PFF was conducted at a level 1 trauma centre. The ePA-AC is a routinely used tool that evaluates pneumonia; confusion, delirium and dementia (CDD); decubitus (Braden Score); the risk of falls; the Fried Frailty index (FFI); and nutrition. Assessment of the novel tool included analysis of its ability to predict complications including delirium, pneumonia and decubitus.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>The novel ePA-AC tool was investigated in 71 geriatric trauma patients. In total, 49 patients (67.7%) developed at least one complication. The most common complication was delirium (n = 22, 44.9%). The group with complications (Group C) had a significantly higher FFI compared with the group without complications (Group NC) (1.7 \u00b1 0.5 vs 1.2 \u00b1 0.4, p = 0.002). Group C had a significantly higher risk score for malnutrition compared with Group NC (6.3 \u00b1 3.4 vs 3.9 \u00b1 2.8, p = 0.004). A higher FFI score increased the risk of developing complications (odds ratio [OR] 9.8, 95% confidence interval [CI] 2.0 to 47.7, p = 0.005). A higher CDD score increased the risk of developing delirium (OR 9.3, 95% CI 2.9 to 29.4, p &lt; 0.001).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>The FFI, CDD, and nutritional assessment tools are associated with the development of complications in geriatric trauma patients with PFF. These tools can support the identification of geriatric patients at risk and might guide individualised treatment strategies and preventive measures.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0284320","type":"journal-article","created":{"date-parts":[[2023,6,9]],"date-time":"2023-06-09T18:04:10Z","timestamp":1686333850000},"page":"e0284320","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["Implementation of a novel nursing assessment tool in geriatric trauma patients with proximal femur fractures"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9582-1810","authenticated-orcid":true,"given":"Till","family":"Berk","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marion","family":"Thalmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai Oliver","family":"Jensen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Schwarzenberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerrolt Nico","family":"Jukema","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans-Christoph","family":"Pape","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sascha","family":"Halvachizadeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2023,6,9]]},"reference":[{"issue":"5","key":"pone.0284320.ref001","doi-asserted-by":"crossref","first-page":"930","DOI":"10.1016\/j.jamcollsurg.2015.12.026","article-title":"Optimal perioperative management of the geriatric patient: a best practices guideline from the American College of Surgeons NSQIP and the American Geriatrics Society.","volume":"222","author":"S Mohanty","year":"2016","journal-title":"J Am Coll Surg"},{"key":"pone.0284320.ref002","first-page":"Cd012485","article-title":"Comprehensive geriatric assessment for older people admitted to a surgical service.","volume":"1","author":"G Eamer","year":"2018","journal-title":"Cochrane Database Syst Rev."},{"issue":"5","key":"pone.0284320.ref003","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1007\/PL00004148","article-title":"World-wide projections for hip fracture.","volume":"7","author":"B Gullberg","year":"1997","journal-title":"Osteoporosis Int"},{"issue":"3","key":"pone.0284320.ref004","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1093\/gerona\/glt105","article-title":"Death, debility, and destitution following hip fracture","volume":"69","author":"GS Tajeu","year":"2014","journal-title":"J Gerontol A Biol Sci Med Sci"},{"issue":"3","key":"pone.0284320.ref005","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1046\/j.1532-5415.2003.51110.x","article-title":"Estimating hip fracture morbidity, mortality and costs.","volume":"51","author":"RS Braithwaite","year":"2003","journal-title":"J Am Geriatr Soc"},{"issue":"6","key":"pone.0284320.ref006","doi-asserted-by":"crossref","first-page":"907","DOI":"10.1097\/SLA.0b013e31821d4a43","article-title":"The impact of complications on costs of major surgical procedures: a cost analysis of 1200 patients","volume":"254","author":"R Vonlanthen","year":"2011","journal-title":"Ann Surg"},{"issue":"2","key":"pone.0284320.ref007","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1007\/s11606-006-0254-1","article-title":"Association of postoperative complications with hospital costs and length of stay in a tertiary care center","volume":"21","author":"NA Khan","year":"2006","journal-title":"J Gen Intern Med"},{"issue":"11","key":"pone.0284320.ref008","doi-asserted-by":"crossref","first-page":"2206","DOI":"10.1016\/j.injury.2015.07.024","article-title":"Complications and patient-reported outcome after hip fracture. 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