Skin property can predict the development of skin tears among elderly patients: a prospective cohort study

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.