Page 14 - 中国全科医学2022-21

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（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 from
16 provinces，two autonomous regions and two municipalities of China，from which 1 067 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 14 675 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%（8 262/14 675）were men，and 43.7%（6 413/14 675）were women；95.5%
（14 020/14 675）were Han people，and 4.5%（655/14 675）were 19 ethnic minorities. The overall prevalence of the three
types of skin injuries was 6.0%（881/14 675），of which the prevalence of PI，IAD，ST and at least two types of skin injuries
was 3.3%（484/14 675），1.4%（199/14 675），0.8%（110/14 675）and 0.6%（88/14 675），respectively. Epidemiologic
characteristics：Han people had higher prevalence of skin injuries compared with ethnic minorities（6.2% vs 2.9%，P=0.001）.
Eighty-year-olds had higher prevalence of skin injuries than 71-80-year-old（10.2% vs 6.1%，P<0.001）and 60-70-year-old
（10.2% vs 3.8%，P<0.001）. Those suffering from at least two chronic diseases had higher prevalence of skin injuries compared
with those without chronic diseases（5.7%-12.0% vs 2.9%，P<0.005）or those with only one chronic disease（5.7%-12.0% vs 4.4%，
P<0.005）. Users of two or more medications had higher prevalence of skin injuries compared with non-medication users（6.1%-
10.2% vs 2.7%，P<0.005）or users of one medication（6.1%-10.2% vs 4.6%，P<0.005）. Those with LOS of over 30 days had
higher prevalence of skin injuries compared with those with LOS of 8-30 days（10.7% vs 4.4%，P<0.016 7 ）or ≤ 7 days（10.7%
vs 7.1%，P<0.016 7）. The prevalence of skin injuries in those with PI risk was higher than that in those without risk（20.5% vs 1.6%，
P<0.05）. The prevalence of skin injuries in dependent-living individuals was higher than that of independent-living individuals
（7.0% vs 0.9%，P<0.05）. The frequently-occurring sites were caudal sacral（57.9%）and heel（14.3%）for PI，peri-anal
region（68.3%）and hip fissure（24.6%）for IAD，and lower limbs（38.2%）and upper limbs（28.2%）for ST. PI combined
with IAD mostly occurred in sacrococcygeal region（71.0%）. PI combined with ST were common in sacrococcygeal region（50.0%）
and heel（35.7%）. ST combined with IAD mostly occurred in caudal sacral（33.3%），perianal region（33.3%）and gluteal
fissure（33.3%）. PI，IAD and ST coexisted mostly in caudal sacral（50.0%）and gluteal fissure（50.0%）. Conclusion
The prevalence of skin injuries in Chinese older people is high，and may increase with age，prevalence of chronic diseases and
use of systemic medications，and dependent-living. In particular，PI risk may be associated with significantly higher possibility
of developing skin injuries. Coexistence of multiple types and anatomical sites of skin injuries are important characteristics. The
above-mentioned epidemiologic characteristics should be considered when formulating prevention strategies of skin injuries in the
elderly.
【Key words】 Wounds and injuries；Aged；Prevalence；Epidemiologic study characteristics；Pressure injury；
Incontinence-associated dermatitis；Skin tear；Multicenter study；Cross-sectionalsurvey

随着老龄化进程的加速，受皮肤和器官老化、肿瘤 皮肤损伤的大范围、跨区域多中心联合调查数据，也无
高发以及慢性病共病等多重影响 ［1-2］ ，老年压力性损伤 法形成针对性的老年皮肤损伤预防策略，为此，开展本
（PI） ［3-4］ 、失禁相关性皮炎（IAD） ［5-6］ 、皮肤撕裂 研究旨在获得我国老年人皮肤损伤患病率及其流行特征
伤（ST） ［7-8］ （以下统称为“老年皮肤损伤”）高发已 的基线数据，为分级干预提供依据。
成为一个突出的健康问题，国内外报道显示老年皮肤损 1 对象与方法
伤发生率为 4.1%~32.2% ［3-8］ ，严重影响了老年人的生 1.1 研究对象 研究项目获得东部战区总医院伦理委
活质量，也增加了医疗费用和家庭照顾负担 ［1，9］ ，成 员批准（2020NZKY-028-01）并在中国临床试验注册中
为全球老年医学和护理面临的巨大挑战和研究重点。国 心注册（注册号：ChiCTR2100042893），采用公开招募、
外研究和全球指南认为，需要对老年皮肤损伤进行全国 课题组审核和签署双向研究协议的方式，纳入 16 个省
或区域性定期调研、监测和重点预防 ［7-9］ ，我国目前已 （江苏省、安徽省、浙江省、云南省、广东省、河南省、
有小范围养老院的老年 PI 调查结果 ［3］ 和住院成人 IAD 陕西省、福建省、黑龙江省、贵州省、湖南省、湖北省、
与 ST 的多中心调查结果 ［10-11］ ，但尚缺乏老年人 3 种 辽宁省、河北省、江西省、山东省）、2 个自治区（广