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Assessment of diaper dermatitis using a novel electronic health record-embedded scale

Journal of Perinatology volume 44, pages 501–507 (2024)Cite this article

Subjects

Abstract

Objective

Quantify the evolution and severity of neonatal skin injury, specifically diaper skin compromise, by embedding a validated skin integrity evaluation into the electronic health record (EHR).

Methods

Retrospective longitudinal cohort analysis of 747 patients stratified by gestation: 22–27, 28–31, 32–24, and 35–37 weeks, from birth to discharge. Primary outcomes were time to first perineal erythema, duration as percent days with erythema, and severity as maximum score. Data were analyzed using generalized linear models and multiple linear regression methods.

Results

Seventy percent had erythema and, of these, 34% had at least one high score with bleeding. Days with erythema ranged from 34–44% (p < 0.05). Days to first erythema were inversely correlated with gestational age. Risks for severe injury included short time to first erythema, 5 or more stools/day, infection, and Caucasian race/ethnicity.

Conclusions

The EHR-based scale can be readily implemented to mitigate diaper skin compromise in premature infants.

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Fig. 1: Severe erythema with bleeding.
Fig. 2: Perianal erythema and stool frequency by GA group.

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Data availability

The datasets generated from the EHR and data analysis are not available publicly due to patient privacy restrictions and regulations. A limited, de-identified dataset may be available from the corresponding author upon reasonable request.

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Acknowledgements

The authors wish to thank the members of the electronic medical record clinical team, Kelly Mathis, for her work on the skin evaluation algorithm and to the clinical staff for their technical support.

Author information

Authors and Affiliations

  1. James L. Winkle College of Pharmacy, University of Cincinnati, Cincinnati, OH, USA

    Marty O. Visscher

  2. Neonatal Intensive Care Unit, University of Cincinnati Medical Center, Cincinnati, OH, USA

    Afshin Taleghani, Melissa Nurre, Ruthann Strange & Melissa Kinnett

  3. College of Medicine, Department of Environmental and Public Health, University of Cincinnati, Cincinnati, OH, USA

    Karthikeyan Meganathan

  4. Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Vivek Narendran

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  1. Marty O. Visscher
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Contributions

The author contributions are as follows. MV and VN conceptualized the project and study design. MV, VN, AT, MN, RS, MK, and KM contributed to the data acquisition, data interpretation, critical review of the manuscript, and final approval of the version being submitted. MV and KM conducted the data analysis. MV, VN, and AT drafted and revised the manuscript for important intellectual content.

Corresponding author

Correspondence to Marty O. Visscher.

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Visscher, M.O., Taleghani, A., Nurre, M. et al. Assessment of diaper dermatitis using a novel electronic health record-embedded scale. J Perinatol 44, 501–507 (2024). https://doi.org/10.1038/s41372-023-01824-z

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