School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, QLD, Australia.
Nutrition and Dietetics & Allied Health Services, The Prince Charles Hospital, Chermside, QLD, Australia.
Int Wound J. 2018 Aug;15(4):527-533. doi: 10.1111/iwj.12893. Epub 2018 May 24.
Skin tears cause pain, increased length of stay, increased costs, and reduced quality of life. Minimal research reports the association between skin tears, and malnutrition using robust measures of nutritional status. This study aimed to articulate the association between malnutrition and skin tears in hospital inpatients using a yearly point prevalence of inpatients included in the Queensland Patient Safety Bedside Audit, malnutrition audits and skin tear audits conducted at a metropolitan tertiary hospital between 2010 and 2015. Patients were excluded if admitted to mental health wards or were <18 years. A total of 2197 inpatients were included, with a median age of 71 years. The overall prevalence of skin tears was 8.1%. Malnutrition prevalence was 33.5%. Univariate analysis demonstrated associations between age (P ˂ .001), body mass index (BMI) (P < .001) and malnutrition (P ˂ .001) but not gender (P = .319). Binomial logistic regression analysis modelling demonstrated that malnutrition diagnosed using the Subjective Global Assessment was independently associated with skin tear incidence (odds ratio, OR: 1.63; 95% confidence interval, CI: 1.13-2.36) and multiple skin tears (OR 2.48 [95% CI 1.37-4.50]). BMI was not independently associated with skin tears or multiple skin tears. This study demonstrated independent associations between malnutrition and skin tear prevalence and multiple skin tears. It also demonstrated the limitations of BMI as a nutritional assessment measure.
皮肤撕裂会导致疼痛、住院时间延长、费用增加和生活质量下降。很少有研究报告使用可靠的营养状况衡量标准来评估皮肤撕裂与营养不良之间的关系。本研究旨在通过对 2010 年至 2015 年期间在一家大都市三级医院进行的昆士兰患者安全床边审计、营养审计和皮肤撕裂审计中纳入的每年住院患者的点患病率,阐述医院住院患者中营养不良与皮肤撕裂之间的关系。如果患者被收入精神科病房或年龄小于 18 岁,则将其排除在外。共有 2197 名住院患者被纳入研究,其平均年龄为 71 岁。皮肤撕裂的总体患病率为 8.1%。营养不良的患病率为 33.5%。单变量分析表明,年龄(P ˂.001)、体重指数(BMI)(P <.001)和营养不良(P ˂.001)与皮肤撕裂之间存在关联,但性别(P =.319)无关。二项逻辑回归分析模型表明,使用主观整体评估诊断的营养不良与皮肤撕裂的发生率(优势比,OR:1.63;95%置信区间,CI:1.13-2.36)和多发性皮肤撕裂(OR 2.48 [95% CI 1.37-4.50])独立相关。BMI 与皮肤撕裂或多发性皮肤撕裂均无独立相关性。本研究表明,营养不良与皮肤撕裂的患病率和多发性皮肤撕裂之间存在独立关联。它还表明 BMI 作为营养评估测量方法的局限性。