Prospective Multicenter Study to Clarify the Frequency of Peristomal Skin Disorders and Appropriate Evaluation Time in Patients with Malignant Rectal Tumors
This study aimed to understand the effectiveness of regular care in reducing the incidence of severe peristomal skin disorders, as well as to identify their risk factors. Peristomal skin disorders occur frequently in outpatient settings and require appropriate intervention. It remains, however, to b...
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| Veröffentlicht in: | Annals of surgery 2024-09 |
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| creator | Shiraishi, Takuya Nishizawa, Yuji Nakajima, Mifumi Kado, Ryoko Ogawa, Hiroomi Naomi, Satoh Owada, Yohei Enomoto, Tsuyoshi Yazawa, Shinji Hamahata, Yukihiro Isogami, Yumi Kitagawa, Kazuo Sakamoto, Maki Enomoto, Hiroya Egawa, Akiko Kitaguchi, Daichi Hasegawa, Hiro Ikeda, Koji Tsukada, Yuichiro Ito, Masaaki |
| description | This study aimed to understand the effectiveness of regular care in reducing the incidence of severe peristomal skin disorders, as well as to identify their risk factors.
Peristomal skin disorders occur frequently in outpatient settings and require appropriate intervention. It remains, however, to be demonstrated when the need to follow up these patients decreases and whether assessing severity of peristomal skin disorders is useful.
This prospective, multicenter, observational cohort study was conducted in six regional high-volume Japanese hospitals. The primary endpoint of the study was the effectiveness of regular follow-up in reducing the incidence of severe peristomal skin disorders via a scoring system at a defined regular outpatient visit. Propensity score matching was performed to compare a control group and patients with severe peristomal skin disorders.
In total, 217 patients between December 2019 and December 2021 were enrolled, and 191 patients were analyzed. Multivariate analysis showed that loop stoma (odds ratio [OR], 5.017; 95% confidence interval [CI], 1.350-18.639; P=0.016) and stoma height of |
| doi_str_mv | 10.1097/SLA.0000000000006522 |
| format | Article |
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Peristomal skin disorders occur frequently in outpatient settings and require appropriate intervention. It remains, however, to be demonstrated when the need to follow up these patients decreases and whether assessing severity of peristomal skin disorders is useful.
This prospective, multicenter, observational cohort study was conducted in six regional high-volume Japanese hospitals. The primary endpoint of the study was the effectiveness of regular follow-up in reducing the incidence of severe peristomal skin disorders via a scoring system at a defined regular outpatient visit. Propensity score matching was performed to compare a control group and patients with severe peristomal skin disorders.
In total, 217 patients between December 2019 and December 2021 were enrolled, and 191 patients were analyzed. Multivariate analysis showed that loop stoma (odds ratio [OR], 5.017; 95% confidence interval [CI], 1.350-18.639; P=0.016) and stoma height of <10 mm (OR, 7.831; 95% CI, 1.760-34.838; P=0.007) were independent risk factors for all peristomal skin disorders. After propensity score matching, the incidence of the disorders was not significantly different between the specified evaluation timing and historical control groups (75.7% vs. 77.2%, P=0.775), and the incidence of the severe disorders based on the ABCD and DET scores (5.9% vs. 19.1%, P<0.001 and 1.5% vs. 29.4%, P<0.001, respectively) was significantly lower in the specified evaluation timing group than in the historical control group.
Regular peristomal skin disease follow-up and scoring, as well as appropriate stoma care at the stoma outpatient visit did not change the frequency of peristomal skin disease, but severe peristomal skin disorders were prevented. Additionally, risk factors for peristomal skin disorders were found to be height <10 mm and loop stoma.</description><identifier>ISSN: 0003-4932</identifier><identifier>ISSN: 1528-1140</identifier><identifier>EISSN: 1528-1140</identifier><identifier>DOI: 10.1097/SLA.0000000000006522</identifier><identifier>PMID: 39239714</identifier><language>eng</language><publisher>United States</publisher><ispartof>Annals of surgery, 2024-09</ispartof><rights>Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0000-0003-3543-1874</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39239714$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shiraishi, Takuya</creatorcontrib><creatorcontrib>Nishizawa, Yuji</creatorcontrib><creatorcontrib>Nakajima, Mifumi</creatorcontrib><creatorcontrib>Kado, Ryoko</creatorcontrib><creatorcontrib>Ogawa, Hiroomi</creatorcontrib><creatorcontrib>Naomi, Satoh</creatorcontrib><creatorcontrib>Owada, Yohei</creatorcontrib><creatorcontrib>Enomoto, Tsuyoshi</creatorcontrib><creatorcontrib>Yazawa, Shinji</creatorcontrib><creatorcontrib>Hamahata, Yukihiro</creatorcontrib><creatorcontrib>Isogami, Yumi</creatorcontrib><creatorcontrib>Kitagawa, Kazuo</creatorcontrib><creatorcontrib>Sakamoto, Maki</creatorcontrib><creatorcontrib>Enomoto, Hiroya</creatorcontrib><creatorcontrib>Egawa, Akiko</creatorcontrib><creatorcontrib>Kitaguchi, Daichi</creatorcontrib><creatorcontrib>Hasegawa, Hiro</creatorcontrib><creatorcontrib>Ikeda, Koji</creatorcontrib><creatorcontrib>Tsukada, Yuichiro</creatorcontrib><creatorcontrib>Ito, Masaaki</creatorcontrib><title>Prospective Multicenter Study to Clarify the Frequency of Peristomal Skin Disorders and Appropriate Evaluation Time in Patients with Malignant Rectal Tumors</title><title>Annals of surgery</title><addtitle>Ann Surg</addtitle><description>This study aimed to understand the effectiveness of regular care in reducing the incidence of severe peristomal skin disorders, as well as to identify their risk factors.
Peristomal skin disorders occur frequently in outpatient settings and require appropriate intervention. It remains, however, to be demonstrated when the need to follow up these patients decreases and whether assessing severity of peristomal skin disorders is useful.
This prospective, multicenter, observational cohort study was conducted in six regional high-volume Japanese hospitals. The primary endpoint of the study was the effectiveness of regular follow-up in reducing the incidence of severe peristomal skin disorders via a scoring system at a defined regular outpatient visit. Propensity score matching was performed to compare a control group and patients with severe peristomal skin disorders.
In total, 217 patients between December 2019 and December 2021 were enrolled, and 191 patients were analyzed. Multivariate analysis showed that loop stoma (odds ratio [OR], 5.017; 95% confidence interval [CI], 1.350-18.639; P=0.016) and stoma height of <10 mm (OR, 7.831; 95% CI, 1.760-34.838; P=0.007) were independent risk factors for all peristomal skin disorders. After propensity score matching, the incidence of the disorders was not significantly different between the specified evaluation timing and historical control groups (75.7% vs. 77.2%, P=0.775), and the incidence of the severe disorders based on the ABCD and DET scores (5.9% vs. 19.1%, P<0.001 and 1.5% vs. 29.4%, P<0.001, respectively) was significantly lower in the specified evaluation timing group than in the historical control group.
Regular peristomal skin disease follow-up and scoring, as well as appropriate stoma care at the stoma outpatient visit did not change the frequency of peristomal skin disease, but severe peristomal skin disorders were prevented. Additionally, risk factors for peristomal skin disorders were found to be height <10 mm and loop stoma.</description><issn>0003-4932</issn><issn>1528-1140</issn><issn>1528-1140</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNpdUU1PGzEQtVARpNB_UKE59rLUH7txfIwCgUpBRCQ9r7ze2cZldx1sL1X-Cz8Wo6QI4Ys9njfz5s0j5Dujl4wq-XO1mF7SD2dccH5ERqzgk4yxnH4ho_QrslwJfkq-hvCXUpZPqDwhp0JxoSTLR-Rl6V3Yoon2GeFuaKM12Ef0sIpDvYPoYNZqb5v03CDMPT4N2JsduAaW6G2IrtMtrB5tD1c2OF-jD6D7GqbbrXdbb3VEuH7W7aCjdT2sbYeQwMsUJqIA_2zcwJ1u7Z9e9xEe0iip4XronA_n5LjRbcBvh_uM_J5fr2e32eL-5tdsusgMS5KynBXGCDS11lSOKyMlqpwxPpFK5KZSk5QV1FTYNLUxuhZG0TFK3tCiqISU4oz82PdNIyd9IZadDQbbVvfohlCKRMO5ouwNmu-hJu0teGzKpLHTflcyWr75UiZfys--pLKLA8NQdVi_F_03QrwCWXGL7A</recordid><startdate>20240906</startdate><enddate>20240906</enddate><creator>Shiraishi, Takuya</creator><creator>Nishizawa, Yuji</creator><creator>Nakajima, Mifumi</creator><creator>Kado, Ryoko</creator><creator>Ogawa, Hiroomi</creator><creator>Naomi, Satoh</creator><creator>Owada, Yohei</creator><creator>Enomoto, Tsuyoshi</creator><creator>Yazawa, Shinji</creator><creator>Hamahata, Yukihiro</creator><creator>Isogami, Yumi</creator><creator>Kitagawa, Kazuo</creator><creator>Sakamoto, Maki</creator><creator>Enomoto, Hiroya</creator><creator>Egawa, Akiko</creator><creator>Kitaguchi, Daichi</creator><creator>Hasegawa, Hiro</creator><creator>Ikeda, Koji</creator><creator>Tsukada, Yuichiro</creator><creator>Ito, Masaaki</creator><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-3543-1874</orcidid></search><sort><creationdate>20240906</creationdate><title>Prospective Multicenter Study to Clarify the Frequency of Peristomal Skin Disorders and Appropriate Evaluation Time in Patients with Malignant Rectal Tumors</title><author>Shiraishi, Takuya ; Nishizawa, Yuji ; Nakajima, Mifumi ; Kado, Ryoko ; Ogawa, Hiroomi ; Naomi, Satoh ; Owada, Yohei ; Enomoto, Tsuyoshi ; Yazawa, Shinji ; Hamahata, Yukihiro ; Isogami, Yumi ; Kitagawa, Kazuo ; Sakamoto, Maki ; Enomoto, Hiroya ; Egawa, Akiko ; Kitaguchi, Daichi ; Hasegawa, Hiro ; Ikeda, Koji ; Tsukada, Yuichiro ; Ito, Masaaki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1014-415cc3ecdaa076bc77e9411287934cb98cc330cbeffdccad3c906e72f055b3773</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shiraishi, Takuya</creatorcontrib><creatorcontrib>Nishizawa, Yuji</creatorcontrib><creatorcontrib>Nakajima, Mifumi</creatorcontrib><creatorcontrib>Kado, Ryoko</creatorcontrib><creatorcontrib>Ogawa, Hiroomi</creatorcontrib><creatorcontrib>Naomi, Satoh</creatorcontrib><creatorcontrib>Owada, Yohei</creatorcontrib><creatorcontrib>Enomoto, Tsuyoshi</creatorcontrib><creatorcontrib>Yazawa, Shinji</creatorcontrib><creatorcontrib>Hamahata, Yukihiro</creatorcontrib><creatorcontrib>Isogami, Yumi</creatorcontrib><creatorcontrib>Kitagawa, Kazuo</creatorcontrib><creatorcontrib>Sakamoto, Maki</creatorcontrib><creatorcontrib>Enomoto, Hiroya</creatorcontrib><creatorcontrib>Egawa, Akiko</creatorcontrib><creatorcontrib>Kitaguchi, Daichi</creatorcontrib><creatorcontrib>Hasegawa, Hiro</creatorcontrib><creatorcontrib>Ikeda, Koji</creatorcontrib><creatorcontrib>Tsukada, Yuichiro</creatorcontrib><creatorcontrib>Ito, Masaaki</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shiraishi, Takuya</au><au>Nishizawa, Yuji</au><au>Nakajima, Mifumi</au><au>Kado, Ryoko</au><au>Ogawa, Hiroomi</au><au>Naomi, Satoh</au><au>Owada, Yohei</au><au>Enomoto, Tsuyoshi</au><au>Yazawa, Shinji</au><au>Hamahata, Yukihiro</au><au>Isogami, Yumi</au><au>Kitagawa, Kazuo</au><au>Sakamoto, Maki</au><au>Enomoto, Hiroya</au><au>Egawa, Akiko</au><au>Kitaguchi, Daichi</au><au>Hasegawa, Hiro</au><au>Ikeda, Koji</au><au>Tsukada, Yuichiro</au><au>Ito, Masaaki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prospective Multicenter Study to Clarify the Frequency of Peristomal Skin Disorders and Appropriate Evaluation Time in Patients with Malignant Rectal Tumors</atitle><jtitle>Annals of surgery</jtitle><addtitle>Ann Surg</addtitle><date>2024-09-06</date><risdate>2024</risdate><issn>0003-4932</issn><issn>1528-1140</issn><eissn>1528-1140</eissn><abstract>This study aimed to understand the effectiveness of regular care in reducing the incidence of severe peristomal skin disorders, as well as to identify their risk factors.
Peristomal skin disorders occur frequently in outpatient settings and require appropriate intervention. It remains, however, to be demonstrated when the need to follow up these patients decreases and whether assessing severity of peristomal skin disorders is useful.
This prospective, multicenter, observational cohort study was conducted in six regional high-volume Japanese hospitals. The primary endpoint of the study was the effectiveness of regular follow-up in reducing the incidence of severe peristomal skin disorders via a scoring system at a defined regular outpatient visit. Propensity score matching was performed to compare a control group and patients with severe peristomal skin disorders.
In total, 217 patients between December 2019 and December 2021 were enrolled, and 191 patients were analyzed. Multivariate analysis showed that loop stoma (odds ratio [OR], 5.017; 95% confidence interval [CI], 1.350-18.639; P=0.016) and stoma height of <10 mm (OR, 7.831; 95% CI, 1.760-34.838; P=0.007) were independent risk factors for all peristomal skin disorders. After propensity score matching, the incidence of the disorders was not significantly different between the specified evaluation timing and historical control groups (75.7% vs. 77.2%, P=0.775), and the incidence of the severe disorders based on the ABCD and DET scores (5.9% vs. 19.1%, P<0.001 and 1.5% vs. 29.4%, P<0.001, respectively) was significantly lower in the specified evaluation timing group than in the historical control group.
Regular peristomal skin disease follow-up and scoring, as well as appropriate stoma care at the stoma outpatient visit did not change the frequency of peristomal skin disease, but severe peristomal skin disorders were prevented. Additionally, risk factors for peristomal skin disorders were found to be height <10 mm and loop stoma.</abstract><cop>United States</cop><pmid>39239714</pmid><doi>10.1097/SLA.0000000000006522</doi><orcidid>https://orcid.org/0000-0003-3543-1874</orcidid></addata></record> |
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| title | Prospective Multicenter Study to Clarify the Frequency of Peristomal Skin Disorders and Appropriate Evaluation Time in Patients with Malignant Rectal Tumors |
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