中国老年人皮肤损伤患病率及其流行特征的多中心横断面研究  

Prevalence and Epidemiologic Features of Skin Injuries in Chinese Older Adults:a Multicenter Cross-sectional Study

作　　者：蒋琪霞 解怡洁 白育瑄 封海霞[4] 陈倩竹[5] 陈德凤[6] 高艳红 王学红 张燕双[9] 潘晓红 潘迎春[11] 赵静[12] 于金美 索惠娟 洪艳燕[15] 展颖颖 李冬梅 刘海燕 李霞 匡丹 彭青 王静 俞萍[23] 陈锐[24] 蔡蕴敏[25] 黄玲 王祖晶 王光扬 郝景平 朱冬梅 JIANG Qixia;XIE Yijie;BAI Yuxuan;FENG Haixia;CHEN Qianzhu;CHEN Defeng;GAO Yanhong;WANG Xuehong;ZHANG Yanshuang;PAN Xiaohong;PAN Yingchun;ZHAO Jing;YU Jinmei;SUO Huijuan;HONG Yanyan;ZHAN Yingying;LI Dongmei;LIU Haiyan;LI Xia;KUANG Dan;PENG Qing;WANG Jing;YU Ping;CHEN Rui;CAI Yunmin;HUANG Ling;WANG Zujing;WANG Guangyang;HAO Jingping;ZHU Dongmei(Department of Burns and Plastic Surgery,General Hospital of Eastern Theater Command,Nanjing 210002,China;Department of Outpatient,Affiliated Hospital of Jiangnan University,Wuxi 214062,China;Clinical Academic Department,Zhejiang Top-medical Medical Dressing Co.,Ltd.,Wenzhou 325027,China;Nursing Department,Zhongda Hospital,Southeast University,Nanjing 210009,China;Orthopedics Department,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China;Department of Gastrointestinal Surgery,the People's Hospital of Guangxi Zhuang Autonomous Region,Nanning 530021,China;Nusing Department,Xing'anmeng People's Hospital,Ulanhot 137400,China;Nursing Department,Suqian First People's Hospital of Nanjing Drum Tower Hospital Group,Suqian 223800,China;Changshu No.2 People's Hospital,Changshu 215500,China;Jingzhou Central Hospital,Jingzhou 434000,China;Nursing Department,Anqing First People's Hospital of Anhui Province,Anqing 246003,China;Department of Outpatient Treatment,Jiangsu Province Hospital,Nanjing 210009,China;Yangzhou Jiangdu People's Hospital,Yangzhou 225200,China;Department of General Surgery,Pizhou People's Hospital,Pizhou 221300,China;Nursing Department,Nanjing Hospital of Chinese Medicine,Nanjing 210001,China;Outpatient Department,Qinhuai Medical Branch,General Hospital of Eastern Theater Command,Nanjing 210008,China;Wound,Ostomy and Continence Nursing Clinic,Guidong People's Hospital of Guangxi Zhuang Autonomous Region,Wuzhou 543099,China;Nursing Department,Siyang Hospital of Chinese Medicine,Suqian 223700,China;Wound and Ostomy Clinic,the Fifth People's Hospital of Wuhu,Wuhu 241000,China;Nursing Department,Affiliated Hospital of Jiangnan University,Wuxi

机构地区：[1]东部战区总医院烧伤整形科,江苏省南京市210002 [2]江南大学附属医院门诊部,江苏省无锡市214062 [3]浙江医鼎医用敷料有限公司临床学术部,浙江省温州市325027 [4]东南大学附属中大医院护理部,江苏省南京市210009 [5]重庆医科大学附属第一医院骨科,重庆市400016 [6]广西壮族自治区人民医院胃肠外科,广西壮族自治区南宁市530021 [7]兴安盟人民医院护理部,内蒙古自治区兴安盟乌兰浩特市137400 [8]南京鼓楼集团医院宿迁市第一人民医院护理部,江苏省宿迁市223800 [9]江苏省常熟市第二人民医院,215500 [10]湖北省荆州市中心医院,434000 [11]安徽省安庆市第一人民医院护理部,246003 [12]江苏省人民医院门诊治疗室,江苏省南京市210009 [13]江苏省扬州市江都人民医院,225200 [14]江苏省邳州市人民医院普外科,221300 [15]江苏省南京市中医院护理部,210001 [16]东部战区总医院秦淮医疗区门诊部,江苏省南京市210008 [17]广西壮族自治区桂东人民医院伤口造口失禁护理门诊,广西壮族自治区梧州市543099 [18]江苏省泗阳县中医院护理部,223700 [19]江苏省芜湖市第五人民医院伤口造口门诊,241000 [20]江南大学附属医院护理部,江苏省无锡市214062 [21]东部战区总医院门诊伤口护理中心,江苏省南京市210002 [22]同济大学附属杨浦医院护理部,上海市200090 [23]江苏省无锡市第二人民医院重症医学科,214002 [24]江西省九江市第一人民医院管理办公室,332001 [25]复旦大学附属金山医院创面诊疗中心,上海市201508 [26]重庆市秀山县人民医院,409900 [27]江苏省苏州市立医院胃肠外科,215000 [28]云南省红河州第一人民医院伤口造口治疗中心,661199 [29]江苏省宿迁市中医院护理部,223800 [30]东部战区总医院护理部,江苏省南京市210002

出　　处：《中国全科医学》2022年第21期2569-2576,共8页Chinese General Practice

基　　金：上海王正国创伤医疗发展基金会课题(WZGF20200101)。

摘　　要：背景人口老龄化是全球医疗保健领域面临的重大挑战,由于病理和生理性皮肤衰老使老年人成为皮肤损伤的高发人群,因此,近年来老年人皮肤损伤的流行病学研究成为研究热点。目的多中心横断面调研住院老年患者压力性损伤(PI)、失禁相关性皮炎(IAD)、皮肤撕裂伤(ST)3种皮肤损伤的患病率和流行特征,为制订老年人皮肤损伤预防策略提供依据。方法以16个省、2个自治区和2个直辖市52所不同等级医院作为多中心调研单位,1067名护士经过课题组线上同质化培训并考试合格后作为资料调研员,2~3人一组采用相同工具和方法对参研医院符合纳入、排除标准的老年人进行全身皮肤检查,发现皮肤损伤者,分别按照国际指南或专家共识推荐的PI定义和分期、IAD定义和分级、ST定义和分级进行识别,同时获取人口学资料、住院时间、既往慢性病史、近1个月用药情况、生活自理情况及有无PI发生风险(采用Braden量表评估)等资料,每组双人签名确定结果,原始数据通过“问卷星”网站上传。采用SPSS 22.0软件进行统计学分析。结果共调研14675例老年患者,问卷有效率100.0%。男、女分别占56.3%(8262/14675)和43.7%(6413/14675);平均年龄(73.5±9.0)岁;中位住院时间7(4,13)d;汉族和19个少数民族老年患者分别占95.5%(14020/14675)和4.5%(655/14675)。PI、IAD、ST及其多种皮肤损伤的总患病率为6.0%(881/14675),其中PI、IAD和ST患病率分别为3.3%(484/14675)、1.4%(199/14675)和0.8%(110/14675),多种皮肤损伤(≥2种共存)患病率为0.6%(88/14675)。流行特征:汉族老年患者皮肤损伤患病率高于少数民族(6.2%vs 2.9%,P<0.05),>80岁老年患者患病率高于71~80岁和60~70岁者(10.2%vs 6.1%vs 3.8%,P<0.0167),患2种及以上慢性病老年患者皮肤损伤患病率高于无慢性病者和患1种慢性病者(5.7%~12.0%vs 2.9%vs 4.4%,P<0.005),使用2种及以上药物的老年患者皮肤损伤患病率高于Background Population aging is a major challenge in the global healthcare field.Due to pathological and physiological changes in ageing skin,skin injuries are highly prevalent in older population.And epidemiological studies on skin injuries in this population has become a research hotspot recently.Objective To examine the prevalence and epidemiological characteristics of three types of skin injuries〔pressure injuries(PI),incontinence-associated dermatitis(IAD)and skin tears(ST)〕in elderly inpatients using a multicenter cross-sectional study,providing a basis for formulating strategies for the prevention of skin injuries in older people.Methods A multicenter study was carried out in 52 hospitals selected from16 provinces,two autonomous regions and two municipalities of China,from which 1067 nurses who had completed the online homogenization training conducted by our research group and passed the relevant examination were selectedas investigators.Every 2-3 nurses were divided into a investigation group.Eligible older inpatients were selected as participants.Full body skin examination for screening skin injuries was conducted in participants in each hospital by nurses using the same tools and methods.PI,IAD and ST were defined and classified by relevant international guideline or expert consensus,respectively.Then demographics,length of stay(LOS),chronic disease history,use of medications in the past month,living independence and risk of PI assessed by the Braden Scale of the participants were collected.After that,two nurses of each group signed to confirm the results,and uploaded to https://www.wjx.cn.SPSS 22.0 was used for statistical analysis.Results A total of 14675 elderly inpatients were investigated,and all of them responded effectively(100.0%).The respondents had an average age of(73.5±9.0)years and a median LOS of 7(4,13)days,among whom 56.3%(8262/14675)were men,and 43.7%(6413/14675)were women;95.5%(14020/14675)were Han people,and 4.5%(655/14675)were 19 ethnic minorities.The overall prevalence of the t

关 键 词：创伤和损伤 老年人 患病率 流行病学研究特征 老年压力性损伤 失禁相关性皮炎 皮肤撕裂伤 多中心研究 横断面研究 

分 类 号：R641[医药卫生—外科学]