Prevalence and risk factors for impaired tissue integrity in long-term care settings: A multicenter study

Abstract

This multicenter, cross-sectional study aimed to determine the prevalence and characteristics of tissue integrity impairments including pressure injuries (PIs), incontinence-associated dermatitis, skin tears, and medical device–related PIs among older adults residing in long-term care settings in Türkiye, and to identify associated risk factors. multicenter study was conducted across eight public and seven private nursing homes and residential care centers in Ankara and Istanbul. The study population comprised 1,657 older adults residing in the participating institutions. Using a total population sampling approach, all eligible residents were invited to participate, and 1,037 older adults were included in the study. Data were collected using the Demographic Characteristics Form, the Braden Pressure Ulcer Risk Assessment Scale, the Ghent Global IAD Categorization Tool (GLOBIAD), the International Skin Tear Advisory Panel (ISTAP) classification, and the Modified Barthel Index (MBI). Descriptive statistics, chi-square tests, t -tests, analysis of variance, and logistic regression analyses were performed. The overall prevalence of tissue integrity impairment was 13.3%, with specific rates of 3.0% for PIs, 9.3% for incontinence-associated dermatitis, 4.5% for skin tears, and 0.3% for medical device–related pressure injuries. PIs were most frequently observed in the sacral region, incontinence-associated dermatitis in the genital area, and skin tears on the upper limbs. Multivariable logistic regression analyses showed that higher body mass index, lower Braden scores, and the presence of neurological disorders significantly increased the likelihood of tissue integrity impairment. These findings emphasize that maintaining skin integrity is a critical component of quality geriatric care, highlighting the need for continuous risk screening, staff education, and proactive prevention strategies to reduce skin-related complications among institutionalized older adults.