Influence of Sociodemographic Variables and the Approach to Incontinence on the Appearance of Incontinence-Associated Dermatitis

Objectives: The general objective of the study was to analyze the influence of sociodemographic factors and care and hygiene practices on the appearance of Incontinence-Associated Dermatitis (IAD). The specific objectives sought to identify the relationship between sociodemographic variables (age, sex, comorbidities) and incidence of IAD, to evaluate hygiene protocols (cleaning products and absorbent handling), and to compare the time of onset of IAD according to the input used. Methods: A multicenter, prospective cohort study was conducted across 10 social health centers. The study population consisted of older institutionalized patients with urinary and/or mixed incontinence who used absorbents continuously. The variables included risk assessment using validated scales, such as the Braden Scale and the Perianal Assessment Tool (PAT), as well as ad hoc questionnaires. Survival analysis to assess the time-to-event onset was performed using the Kaplan-Meier curve and the Log-Rank test. Results: A statistically significant relationship was found between the occurrence of IAD and the risk detected by the Braden scale (p=0.004) and the PAT scale (p=0.02). However, no statistically significant relationship was found with age, sex, or the Barthel Index. Regarding hygiene, soapy wipes were associated with the highest incidence of IAD, while dry wipes were the most effective method, with the lowest cumulative risk and the longest time-to-event (p=0.001). The absorbent brand had a significant influence (p=0.024), suggesting that the "B" brand prevented one injury per six patients compared with the "A" brand. The frequency of absorbent changes did not show a statistically significant association. Conclusions: The risk of developing IAD is strongly linked to the scores of the Braden and PAT scales, the brand of the absorbent ("B" being more effective), and the hygiene method, where dry wipes were found to be the most protective against soapy ones. On the other hand, factors such as age, sex, degree of dependence (Barthel), or frequency of change of the absorbent did not show a significant influence on the appearance of the lesion.