基于非平衡样本校正的皮肤病住院病人医用粘胶相关性皮肤损伤的危险因素OA

Objective:To investigate the risk factors for medical adhesive-related skin injury(MARSI)among dermatology inpatients and to provide better evidence base for MARSI prevention in this patient population.Methods:A retrospective study was conducted.A total of 752 dermatology inpatients admitted to a grade A tertiary hospital in Guangzhou,Guangdong province,from January 2021 to December 2023 were enrolled and divided into the MARSI group(n=83)and the non-MARSI group(n=669).For the class imbalance problem of sample 1:8,a balanced subset was constructed using baseline characteristic stratified sampling.LASSO regression was then performed in a dual-dimension approach,using both the balanced subset and the imbalanced total sample,for variable selection.Six variables were ultimately selected,which were length of hospital stay,hypertension(yes/no),hemoglobin level,erosive lesions(yes/no),scaling(yes/no),and corticosteroid use.A multivariate Logistic regression model was constructed,so as to analyze their association between these variables and MARSI occurrence.Results:The incidence of MARSI among dermatology inpatients was 11.04％.Multivariate Logistic regression analysis showed that longer hospital stay,hypertension,presence of erosive lesions,presence of scaling,and corticosteroid use were independent risk factors for MARSI in dermatology inpatients,whereas normal hemoglobin level was an independent protective factor.Conclusions:MARSI occurrence in dermatology inpatients is closely associated associated with length of hospital stay,hypertension,secondary skin lesions(erosions and scaling),and corticosteroid use,while normal hemoglobin level exerts a protective effect.The LASSO-Logistic regression model based on non-equilibrium sample correction has improved the accuracy of risk factor screening and has provided a more reliable methodological reference for MARSI risk assessment in dermatology patients.In clinical practice,it is recommended to shift toward a skin barrier function-centered MARSI risk stratification management strategy,implement targeted protective measures and optimize adhesive use strategies protocols,thereby reducing the occurrence of secondary skin injury in dermatology patients.