OBJECTIVE 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. SUMMARY BACKGROUND DATA 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. METHODS 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. RESULTS 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. CONCLUSION 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.

中文翻译：

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旨在明确直肠恶性肿瘤患者造口周围皮肤疾病发生频率和适当评估时间的前瞻性多中心研究。


目的 本研究旨在了解定期护理在降低严重造口周围皮肤疾病发生率方面的有效性，并确定其危险因素。摘要背景数据造口周围皮肤疾病在门诊经常发生，需要适当的干预。然而，何时减少对这些患者的随访以及评估造口周围皮肤疾病的严重程度是否有用仍有待证明。方法 这项前瞻性、多中心、观察性队列研究在日本六家地区性大医院进行。该研究的主要终点是通过定期门诊的评分系统进行定期随访，以降低严重造口周围皮肤疾病的发生率。进行倾向评分匹配以比较对照组和患有严重造口周围皮肤疾病的患者。结果 总共入组了2019年12月至2021年12月期间的217名患者，并对191名患者进行了分析。多变量分析显示，环造口（比值比 [OR]，5.017；95% 置信区间 [CI]，1.350-18.639；P=0.016）和造口高度 <10 mm（OR，7.831；95% CI，1.760-34.838） ; P=0.007) 是所有造口周围皮肤疾病的独立危险因素。倾向评分匹配后，指定评估时间组和历史对照组之间的疾病发生率没有显着差异（75.7% vs. 77.2%，P=0.775），并且基于ABCD和DET评分的严重疾病发生率（分别为 5.9% vs. 19.1%，P<0.001 和 1.5% vs. 29.4%，P<0.001）在指定的评估时间组中显着低于历史对照组。 结论 定期进行造口周围皮肤病随访和评分，以及在造口门诊就诊时进行适当的造口护理不会改变造口周围皮肤病的发生频率，但可以预防严重的造口周围皮肤病。此外，发现造口周围皮肤疾病的危险因素是高度 <10 mm 和环造口。