Department of Skincare Science, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, Japan; Global Nursing Research Center, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, Japan.
Department of Skincare Science, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo, Japan.
J Tissue Viability. 2021 May;30(2):155-160. doi: 10.1016/j.jtv.2021.02.010. Epub 2021 Mar 2.
[Aim] Because painful skin tears frequently occur in older patients, the prevention of skin tears is fundamental to improve their quality of life. However, a risk assessment tool for skin tears has not been established yet in Japan. Therefore, we aimed to propose a risk scoring tool for skin tears in Japanese older adult. [Methods] We conducted a prospective cohort study with 6-month follow-up in two long-term care hospitals in Japan. A total of 257 inpatients were recruited. Patient and skin characteristics were collected at baseline, and the occurrence of forearm skin tears were examined during follow-up. To develop a risk scoring tool, we identified risk factors, and converted their coefficients estimated in the multiple logistic regression analysis into simplified scores. The predictive accuracy of the total score was evaluated. [Results] Of 244 participants, 29 developed forearm skin tears during the follow-up period, a cumulative incidence of 13.5%. Senile purpura, pseudoscar, contracture, and dry skin were identified as risk factors for skin tears. Their weighted scores were 6, 4, 5, and 6, respectively. The area under the receiver operating characteristic curve of the total score was 0.806. At a cut-off score of 12, the sensitivity was 0.86, and the specificity was 0.67. [Conclusion] Our forearm skin tear risk scoring tool showed high accuracy, whereas specificity was low. This tool can contribute to prevent forearm skin tears in Japanese older adults.
[目的] 由于老年患者经常发生疼痛性皮肤撕裂，因此预防皮肤撕裂对于提高他们的生活质量至关重要。然而，在日本尚未建立皮肤撕裂的风险评估工具。因此，我们旨在提出一种适用于日本老年人群的皮肤撕裂风险评分工具。[方法] 我们在日本的两家长期护理医院进行了一项前瞻性队列研究，随访时间为 6 个月。共招募了 257 名住院患者。在基线时收集患者和皮肤特征，并在随访期间检查前臂皮肤撕裂的发生情况。为了开发风险评分工具，我们确定了风险因素，并将多变量逻辑回归分析中估计的系数转换为简化得分。评估了总分的预测准确性。[结果] 在 244 名参与者中，有 29 名在随访期间发生了前臂皮肤撕裂，累积发生率为 13.5%。老年紫癜、假性瘢痕、挛缩和皮肤干燥被确定为皮肤撕裂的危险因素。它们的加权得分为 6、4、5 和 6。总分的受试者工作特征曲线下面积为 0.806。在截断值为 12 时，敏感性为 0.86，特异性为 0.67。[结论] 我们的前臂皮肤撕裂风险评分工具具有较高的准确性，但其特异性较低。该工具有助于预防日本老年人群的前臂皮肤撕裂。
