Skin property can predict the development of skin tears among elderly patients: a prospective cohort study
Skin property can predict the development of skin tears among elderly patients: a prospective cohort study
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DOI：
10.1111/iwj.12675
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发表时间：
2017-08-01
影响因子：
3.1
通讯作者：
Sanada, Hiromi
中科院分区：
文献类型：
--
作者：
Koyano, Yuiko;Nakagami, Gojiro;Sanada, Hiromi
本研究的目的是确定皮肤特性，可用于预测老年患者皮肤撕裂（ST）的发展。在日本一家长期医疗机构的65岁及以上老年患者（N=149）中进行了一项为期8个月的前瞻性队列研究。使用20 MHz超声扫描仪测量前臂的基线皮肤特性，该扫描仪测量真皮层和低回声像素的厚度，并使用皮肤印迹法评估IV型胶原蛋白、基质金属蛋白酶-2和肿瘤坏死因子-α的水平。使用考克斯比例风险模型获得主要混杂因素的校正风险比（HR）。在21例患者中共记录了52例ST，导致发生率为113/1000人日。ST的预测因子是真皮厚度（HR=052; 95%置信区间=033-081; P值=0004）。真皮厚度的截止点为080 mm（曲线下面积=077; 95%置信区间=066-088; P值=0006）。我们的研究结果表明，测量基线处的真皮厚度是识别高危患者的一种简单而准确的方法。
The aim of this study was to identify skin properties that may be used to predict the development of a skin tear (ST) among elderly patients. A prospective cohort study was conducted among elderly patients aged 65 and older (N=149) at a long-term medical facility in Japan over an 8-month period. Skin properties at baseline were measured on the forearm using a 20-MHz ultrasound scanner, which measured the thickness of the dermis layer and low-echogenic pixels, and skin blotting method, which evaluated the levels of collagen type IV, matrix metalloproteinase-2 and tumour necrosis factor-alpha. Adjusted hazard ratios (HRs) for the main confounders were obtained using the Cox proportional hazard model. A total of 52 STs were recorded among the 21 patients, resulting in an incidence rate of 113/1000 person-days. The predictor of STs was dermis thickness (HR=052; 95% confidence interval=033-081; P-value=0004). The cut-off point for dermis thickness was 080mm (area under the curve=077; 95% confidence interval=066-088; P-value=0006). Our results suggest that measuring the dermis thickness at baseline is an easy and accurate way to identify a high-risk patient.