Associations between individual characteristics and incontinence-associated dermatitis: a secondary data analysis of a multi-centre prevalence study

Background: Incontinent patients are at risk for incontinence-associated dermatitis. Prolonged exposures of the skin to urine and/or stool are causal factors but the exact aetiology and pathophysiology are not fully understood.

Objectives: The aim of the current investigation was to identify person and health-related variables most strongly associated with incontinence-associated dermatitis development.

Design: Secondary data analysis of a multicentre-prevalence study in 2012.

Settings: Hospitals, nursing homes, home care in Austria and the Netherlands.

Participants: Nursing home residents, hospital patients, home care clients who completed an incontinence assessment and who were incontinent (n = 3713). Mean age 81.2 (SD 11.2) years.

Methods: Demographic, functional and physiological parameters were compared between subjects with incontinence-associated dermatitis and without. A logistic regression model predicting incontinence-associated dermatitis was build.

Results: Subjects with incontinence-associated dermatitis were statistically significantly more often male, had more often diabetes mellitus, had a higher BMI, were less often affected by urinary but more often by faecal incontinence and showed higher degrees of functional and psychical impairments. Being faecal incontinent (OR 1.70; 95% Cl 1.14-2.55), having diabetes mellitus (OR 1.46; 95% CI 1.03-2.06) and having "friction and shear" problems (OR 0.65; 95% CI 0.51-0.81) according to the Braden scale item were the strongest covariates for the presence of incontinence-associated dermatitis.

Conclusions: It is recommended to target special preventive skin care interventions especially to persons who are faecal incontinent and who have moist perineal skin, who have higher BMIs, who are diabetics, and who need increased assistance in moving. (C) 2014 Elsevier Ltd. All rights reserved.