title: Skin property can predict the development of skin tears among elderly patients: a prospective cohort study.
abstract: 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 1·13/1000 person-days. The predictor of STs was dermis thickness (HR = 0·52; 95% confidence interval = 0·33-0·81; P-value = 0·004). The cut-off point for dermis thickness was 0·80 mm (area under the curve = 0·77; 95% confidence interval = 0·66-0·88; P-value = 0·006). Our results suggest that measuring the dermis thickness at baseline is an easy and accurate way to identify a high-risk patient.
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: 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: 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
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
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005542:Forearm / Q000502:physiology*; D006801:Humans; D007564:Japan; D022125:Lacerations / Q000209:etiology* / Q000503:physiopathology*; D008297:Male; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012422:Rupture, Spontaneous / Q000503:physiopathology*; D012867:Skin / Q000503:physiopathology*; D015595:Skin Aging / Q000502:physiology*; D012879:Skin Physiological Phenomena
keywords: Aged; Long-term care; Nursing; Traumatic wound; Ultrasound scanner