危重症老年患者发生失禁相关性皮炎的影响因素  

Influencing Factors of Incontinence-associated Dermatitis in Critically Ill Elderly Patients

作　　者：肖玲 周世群[1] 娄兰兰 姚淑斌 XIAO Ling;ZHOU Shiqun;LOU Lanlan;YAO Shubin(Department of Geriatrics,The Second Affiliated Hospital of Chongqing Medical University,Chongqing,400010,China)

机构地区：[1]重庆医科大学附属第二医院老年医学科,重庆400010

出　　处：《中外医疗》2025年第7期13-16,共4页China & Foreign Medical Treatment

摘　　要：目的分析危重症老年住院患者发生失禁相关性皮炎(incontinence-associated dermatitis,IAD)的影响因素。方法回顾性选取2023年3月—2024年1月重庆医科大学附属第二医院收治的60例危重症老年患者的临床资料,收集所有患者的一般资料并进行分析,探究该类患者发生IAD的影响因素。结果60例危重症老年患者中15例患者发生IAD,发生率为25.00%,IAD患者和非IAD患者的年龄、Barthel指数、血清白蛋白水平、大便性状、Braden评分、失禁类型、会阴皮肤评估工具评分、皮肤状况评分工具评分、营养支持类型、机械通气和意识障碍比较,差异均有统计学意义(P均<0.05)。多因素二元Logistic回归分析显示,血清白蛋白水平≥35 g/L(OR=0.791,95%CI:0.344~0.827)和Braden评分≥18分(OR=0.401,95%CI:0.274~0.954)是危重症老年患者发生IAD的独立保护因素(P均<0.05);大小便失禁(OR=1.744,95%CI:1.141~7.443)、流水状大便(OR=1.996,95%CI:1.117~2.826)和存在意识障碍(OR=1.745,95%CI:1.067~4.226)是危重症老年患者发生IAD的独立危险因素(P均<0.05)。结论危重症老年患者发生IAD的独立危险因素有大小便失禁、流水状大便和存在意识障碍,血清白蛋白水平≥35 g/L和Braden评分≥18分是危重症老年患者发生IAD的独立保护因素,针对以上因素给予患者预防措施,进一步降低IAD的发生率。Objective To analyze the influencing factors of incontinence-associated dermatitis(IAD)in critically ill elderly inpatients.Methods The clinical data of 60 critically ill elderly patients admitted to The Second Affiliated Hospital of Chongqing Medical University from March 2023 to January 2024 were retrospectively selected.The general data of all patients were collected and analyzed to explore the influencing factors of IAD in such patients.Results IAD occurred in 15 of 60 critically ill elderly patients,with an incidence of 25.00%.There were statistically significant differences in age,Barthel Index,serum albumin level,stool characteristics,Braden score,incontinence type,Perineal Assessment Tool score,Skin Condition Assessment Tool score,nutritional support type,mechanical ventilation and disturbance of consciousness between IAD patients and non-IAD patients(all P<0.05).Multivariate Logistic regression analysis showed that serum albumin level≥35 g/L(OR=0.791,95%CI:0.344-0.827)and Braden score≥18 points(OR=0.401,95%CI:0.274-0.954)were independent protective factors for IAD in critically ill elderly patients(both P<0.05).Incontinence(OR=1.744,95%CI:1.141-7.443),watery stool(OR=1.996,95%CI:1.117-2.826)and disturbance of consciousness(OR=1.745,95%CI:1.067-4.226)were independent risk factors for IAD in critically ill elderly patients(all P<0.05).Conclusion The independent risk factors for IAD in critically ill elderly patients are incontinence,watery stool and disturbance of consciousness.Serum albumin level≥35 g/L and Braden score≥18 points are independent protective factors for IAD in critically ill elderly patients.Preventive measures are given to patients to further reduce the incidence of IAD.

关 键 词：危重症 失禁相关性皮炎 影响因素 回归分析 

分 类 号：R4[医药卫生—临床医学]