Background: Skin is considered the largest organ of the body and, as other organs, may become dysfunctional at the end of life. In this context, skin dysfunction is associated with decreased cutaneous perfusion, which leads to local hypoxia, and for failing to maintain its normal function, inevitable changes may occur. Aim: To estimate and evaluate the incidence and predictors of skin changes in hospitalized patients in terminal phase of the disease and at the end of life. Methods: This prospective cohort study was conducted in an inpatient palliative care unit. Twenty-four patients were followed until discharge, transfer, or death. Some instruments, including the Edmonton Symptom Assessment System, Malnutrition Screening Tool, Palliative Performance Scale, Braden Scale and Pressure Ulcer Scale for Healing, were used in the assessments of patients. The Wilcoxon Mann-Whitney U-test, chi-square test, Fisher’s test, Kaplan-Meier curve, Log-rank test, and Classification and Regression Tree analysis were performed for data analysis. Results: Most patients were women (13, 54.2%), the mean age was 67.6 years (SD=21.8), the majority of patients (23, 95.8%) had lost ≤50% of their functional capacity and had some degree of malnutrition (15, 62.5%). The incidence of skin changes was 16.7%; cases of grayish skin (n=2), yellowgreenish skin (n=1), and pressure injuries no Kennedy type (n=9) were detected. The number of patients who died was significantly higher among those with skin changes than among those without such changes (p=0.035), and patients with skin changes were 17 times more likely to die than those without changes. Age ≤50 years was predictive of skin changes in the study population. Conclusion: The incidence of skin changes was 16.7%, with predominance of pressure injuries. It was also found that patients with skin changes at the end of life were more likely to die when compared to those without such changes.
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