Prevalence of skin tears in the extremities among elderly residents at a nursing home in Denmark

The aims of the study were to determine the prevalence of skin tears in the extremities and to explore factors associated with development of skin tears in inpatients at a Danish hospital. The study was designed as a point prevalence survey and included 202 patients in the age range 19-99 (mean: 70·7, SD: 16·5). The patients were assessed for presence of skin tears, numbers, locations and previous skin tears. Data were collected using a data collection sheet developed for a previous study. The survey team consisted of four specialist nurses. Data were collected over a period of 24 hours spread over 3 days. Of the 202 patients, 23 had skin tears, yielding a prevalence of 11·4%. In total, 40 skin tears were observed. Multiple logistic regression analysis showed that previous skin tears (odds ratio (OR): 9·3, 95% confidence interval (CI): 2·6-33·4, P < 0·001), ecchymosis (OR: 5·6, CI: 1·4-23·2, P < 0·017) and risk of falling (OR: 3·8, CI: 1·2-12·0, P < 0·021) were significantly associated with development of skin tears. The prevalence of skin tears in this study (11·4%) matches other international observations. The following risk factors were recognised: previous skin tear, ecchymosis and risk of falling. These factors could be used to identify patients requiring prevention of skin tears.

Section: Discussionmentioning

confidence: 99%

“…The data were collected by using a data collection sheet developed for a previous study (Figure 1, Datasheet) (13). The datasheet contained demographic data and clinical information.…”

Section: Surveyors and Data Collectionmentioning

confidence: 99%

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Prevalence of skin tears in the extremities in inpatients at a hospital in Denmark

Bermark

Wahlers

Gerber

et al. 2018

“…Participants with a history of skin tears were nearly four times more likely to develop a skin tear at 6 months. Three previous studies reported similar outcomes, but variation in their research design and the limited quantitative analysis did not permit further evaluation . LeBlanc et al suggested that a possible relationship existed between having a history of skin tears and the occurrence of skin tears.…”

Section: Discussionmentioning

confidence: 99%

A risk model for the prediction of skin tears in aged care residents: A prospective cohort study

Rayner

Carville

Leslie

et al. 2018

The objective of this study was to construct a predictive model to identify aged care residents at risk of future skin tears. Extensive data about individual characteristics, skin characteristics, and skin properties were gathered from 173 participants at baseline and at 6 months. A predictive model, developed using multivariable logistic regression, identified five variables that significantly predicted the risk of skin tear at 6 months. These included: a history of skin tears in the previous 12 months (OR 3.82 [1.64-8.90], P = 0.002), purpura ≤20 mm in size (OR 3.64 [1.42-9.35], P = 0.007), a history of falls in the previous 3 months (OR 3.37 [1.54-7.41], P = 0.002), clinical manifestations of elastosis (OR 3.19 [1.38-7.38], P = 0.007), and male gender (OR 3.08 [1.22-7.77], P = 0.017). The predictive model yielded an area under the receiver operating characteristic curve of 0.854 with an 81.7% sensitivity and an 81.4% specificity. This predictive model could inform a simple but promising bedside tool for identifying older individuals at risk of skin tears.

“…9 A higher value was found in a study conducted in Denmark, with a prevalence of 11.4% in 202 patients admitted at a hospital of the same level. 10 Among studies performed in long-term care facilities for the elderly, the ST prevalence found was of 3% in Belgium, 11 4.6% in Denmark, 12 11.6% in Brazil, 13 and 14.7% in Canada. 14 Some studies have indicated associations between ST occurrence and low scores in the Braden scale.…”

mentioning

confidence: 97%

ISTAP classification for skin tears: Validation for Brazilian Portuguese

Silva

Campanili²,

Freitas

et al. 2019

The objective of this study was to evaluate interobserver reliability and the concurrent criterion validity of the adapted version of the International Skin Tear Advisory Panel (ISTAP) Skin Tear Classification System to Brazilian Portuguese. For the evaluation of interobserver reliability using the photograph database, 36 nurses classified 30 skin tears (STs) into three groups, according to its definitions (adapted version). For the evaluation through clinical application, 23 nurses classified 12 STs present in 8 thoracic and cardiovascular postoperative patients at a tertiary hospital in Sao Paulo, Brazil. For the data collection of patients, an enterostomal therapist nurse classified the ST found by simultaneously using the adapted ISTAP version and the Skin Tear Audit Research (STAR) Classification System to test the concurrent criterion validity. The average of 17.83 correct answers (SD = 5.03) resulted from 1080 photograph observations, with Fleiss κ = 0.279 (reasonable concordance level). The interobserver reliability in the clinical application resulted in a global correct answer percentage of 76.7% in 85 observations. The concurrent criterion validity was attested by the total correlation (r = 1) between ISTAP and STAR. The ISTAP classification for ST is a reliable instrument and also valid in Brazil, making it another option to be used in clinical practice.