In the Department of General Surgery, Xuanwu Hospital Capital Medical University, Beijing, China, Yu Zhang, MS, RN, is a nursing student; Shuo Wang, BS, RN, is Head Nurse; Xiaoxue Zhang, MS, RN, is a registered nurse; Wenting Zhang, BS, RN, is Head Nurse; and Xinran Wang, BS, RN, is Associate Professor. Acknowledgments: The authors thank the medical workers and patients who participated in this research. The authors have disclosed no financial relationships related to this article. Submitted April 26, 2019; accepted in revised form July 17, 2019.
Adv Skin Wound Care. 2020 May;33(5):260-266. doi: 10.1097/01.ASW.0000658584.09988.fa.
To determine the incidence and influencing factors of medical adhesive-related skin injury (MARSI) among ICU patients.
Study authors enrolled patients admitted to two ICUs at a class 3, grade A hospital in Beijing between January and June 2018 in this prospective cohort study. A data collection sheet was designed, and the data were collected by querying the electronic medical record and via direct assessment. Univariate and multivariate logistic regression analyses were performed to identify factors that independently influenced MARSI incidence. The STROBE checklist was used.
In total, 39 of 356 patients (27 men and 12 women with an average age of 61.51 ± 17.49 years) developed MARSI, an incidence of 10.96%. The median time from admission to MARSI occurrence was 26 days. Multivariate logistic regression analysis revealed that the ICU length of stay, Braden Scale score, and mechanical ventilation all independently influenced incidence. The Braden Scale score (odds ratio [OR], 0.758; 95% confidence interval [CI], 0.636-0.904; P < .05) was a protective factor against MARSI, with higher scores indicating lower risk. The ICU length of stay (OR, 1.098; 95% CI, 1.061-1.136; P < .05) and mechanical ventilation (OR, 3.373; 95% CI, 0.889-12.795; P < .05) were independent risk factors for MARSI.
The incidence of MARSI in ICU patients was relatively high. Awareness of MARSI should be increased among medical staff, and proper skin care should be provided to prevent and treat MARSI effectively.
确定 ICU 患者中与医用胶粘剂相关的皮肤损伤（MARSI）的发生率和影响因素。
研究作者采用前瞻性队列研究方法，纳入 2018 年 1 月至 6 月期间在北京一家 3 级甲等医院的 2 个 ICU 病房收治的患者。设计了一份数据采集表，通过查询电子病历和直接评估来收集数据。采用单因素和多因素 logistic 回归分析来确定独立影响 MARSI 发生率的因素。采用 STROBE 清单。
共有 39 例 356 例患者（27 例男性，12 例女性，平均年龄 61.51±17.49 岁）发生了 MARSI，发生率为 10.96%。从入院到 MARSI 发生的中位时间为 26 天。多因素 logistic 回归分析显示，ICU 住院时间、Braden 量表评分和机械通气均独立影响发生率。Braden 量表评分（比值比[OR]，0.758；95%置信区间[CI]，0.636-0.904；P<.05）是 MARSI 的保护因素，评分越高风险越低。ICU 住院时间（OR，1.098；95% CI，1.061-1.136；P<.05）和机械通气（OR，3.373；95% CI，0.889-12.795；P<.05）是 MARSI 的独立危险因素。
ICU 患者中 MARSI 的发生率相对较高。医务人员应提高对 MARSI 的认识，提供适当的皮肤护理，以有效预防和治疗 MARSI。
