Jiang T, Zhang X, Wu J, Gao L, Tung TH, et al.
Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy an.... Date of publication 2025 Jan 1;volume 52(1):66-75.
1. J Wound Ostomy Continence Nurs. 2025 Jan-Feb 01;52(1):66-75. doi:
10.1097/WON.0000000000001146. Epub 2025 Jan 13.
Risk Factors for Incontinence-Associated Dermatitis in Adults: A Systematic
Review and Meta-Analysis.
Jiang T(1)(2)(3)(4)(5), Zhang X(1)(2)(3)(4)(5), Wu J(1)(2)(3)(4)(5), Gao
L(1)(2)(3)(4)(5), Tung TH(1)(2)(3)(4)(5).
Author information:
(1)Tianxiang Jiang, BS, RN, Intensive care unit, Taizhou Hospital of Zhejiang
Province affiliated to Wenzhou Medical University, Linhai, Zhejiang Province,
China, School of Nursing, Dalian University, Dalian City, Liaoning Province,
China.
(2)Xiuzhi Zhang, BS, RN, Cardiology Department, Taizhou Hospital of Zhejiang
Province affiliated to Wenzhou Medical University, Linhai, Zhejiang Province,
China.
(3)Jinju Wu, BS, RN, Emergency Medical Rescue Center of Yuncheng City, Yuncheng
City, Shanxi Province, China.
(4)Lei Gao, BS, RN, School of Nursing, Dalian University, Dalian City, Liaoning
Province, China.
(5)Tao-Hsin Tung, PhD, Director, Evidence-based Medicine Center, Taizhou
Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Linhai,
Zhejiang Province, China.
PURPOSE: A meta-analysis was conducted to comprehensively identify risk factors
of incontinence-associated dermatitis (IAD) in adults and provide evidence-based
support for healthcare professionals to formulate IAD preventive interventions
and bundled interventions.
METHODS: Systematic review and meta-analysis of pooled findings.
SEARCH STRATEGY: Two researchers independently searched databases PubMed, EBSCO,
Cochrane Library, Embase, Medline, Web of Science and Scopus and 4 Chinese
databases (CNKI, Wanfang Data, VIP and CBM) for relevant studies published from
their inception to March 15, 2023. Two researchers independently extracted
relevant data and literature characteristics and evaluated the quality of the
included studies.
FINDINGS: Twenty-seven studies that collectively enrolled 4046 participants were
included in our systematic review. Five were written in English, 1 was written
in Spanish, and the other 21 were written in Chinese. The odds ratios (ORs) and
95% confidence intervals (CIs) of the risk factors for IAD were determined.
Fecal incontinence, an etiologic factor (OR = 5.79; 95% CI = [1.88-17.87]),
stool characteristics (OR = 5.28; 95% CI = [2.51-11.07]), and daily frequency of
bowel movements (OR = 5.76; 95% CI = [4.48-7.42]) were associated with an
increased likelihood of IAD. The following risk factors: fever (OR = 4.23; 95%
CI = [1.89-9.46]), age (OR = 1.04; 95% CI = [1.01-1.09]), hypoproteinemia
(OR = 3.30; 95% CI = [1.90-5.72]), impaired consciousness (OR = 2.43; 95%
CI = [1.66-3.54]), days of antibiotic use (OR = 4.13; 95% CI = [3.11-5.49]),
diabetes mellitus (OR = 2.90; 95% CI = [1.73-4.86]), and a higher overall
Perineal Assessment Tool (PAT) score (OR = 2.56; 95% CI = [1.23-5.30]) emerged
as independent risk factors for IAD in adult patients. In contrast, a higher
serum albumin level (OR = 0.88; 95% CI = [0.84-0.93]), a higher Braden Scale for
Predicting Pressure Score Risk (Braden Scale) score (OR = 0.66; 95%
CI = [0.56-0.77]), and a higher Braden Scale mobility subscale score (OR = 0.86;
95% CI = [0.74-1.00]) were protective factors that reduced the likelihood of
IAD.
IMPLICATIONS: Identification of risk factors for IAD may be used to identify
patients at risk and in need of preventive interventions. Identification of
modifiable risk factors may be used to design novel preventive interventions.
Copyright © 2025 by the Wound, Ostomy, and Continence Nurses Society.
DOI: 10.1097/WON.0000000000001146
PMID: 39836004 [Indexed for MEDLINE]
