title: Incidence of skin tears in the extremities among elderly patients at a long-term medical facility in Japan: A prospective cohort study.
abstract: OBJECTIVE
  There is a lack of data from cohort studies for the incidence of skin tears among an elderly population in an Asian country. We estimated the cumulative incidence of skin tear, and identify its risk factor.
  
  
  METHODS
  The present prospective cohort study was carried out at a long-term medical facility in Japan. Participants included patients (n = 368) aged 65 years or older receiving hospital care. The 3-month cumulative incidence of skin tears was estimated by identifying them using direct inspection of the extremities. In order to find the risk factors for the skin tear incidence, odds ratios and their 95% confidence intervals of skin tear development in association with the factors were estimated using logistic regression analyses.
  
  
  RESULTS
  A total of 14 patients developed skin tears, and their cumulative incidence was 3.8%. No patients with skin tears developed multiple wounds on their extremities. Half of the skin tears occurred on the outside of the right forearm, and just three skin tears were found in the lower legs. Multiple logistic analyses showed that pre-existing skin tears (odds ratio 15.42, 95% confidence interval 3.53-67.43, P < 0.001) and a 6-point decrease in the total score of the Braden Scale (odds ratio 0.10, 95% confidence interval 0.01-0.83, P < 0.033) were significantly associated with skin tear development.
  
  
  CONCLUSIONS
  Patients with pre-existing skin tears and a low score of the Braden Scale have a higher risk of skin tear development during 3 months. These factors could be used to identify patients requiring prevention care for skin tears.
authors.affiliation: Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Hiromi
authors.initials: H
authors.lastname: Sanada
authors.affiliation: Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Gojiro
authors.initials: G
authors.lastname: Nakagami
authors.affiliation: Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Yuiko
authors.initials: Y
authors.lastname: Koyano
authors.affiliation: Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Iizaka
authors.affiliation: Wellness Promotion Science Center, Institute of Medical Pharmaceutical and Health Sciences, Kanazawa University, Ishikawa, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Sugama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001132:Arm; D015331:Cohort Studies; D016001:Confidence Intervals; D005260:Female; D015577:Geriatric Assessment; D006225:Hand; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D007866:Leg; D016015:Logistic Models; D008134:Long-Term Care / Q000379:methods*; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D061214:Patient Safety / Q000706:statistics & numerical data; D003668:Pressure Ulcer / Q000175:diagnosis / Q000453:epidemiology*; D011446:Prospective Studies; D018570:Risk Assessment; D012866:Skilled Nursing Facilities / Q000706:statistics & numerical data*; D012867:Skin / Q000293:injuries*
keywords: dermatology; epidemiology; nursing care; preventive medicine; skin tears