{"title":"The frequency of osteomyelitis after pressure injury in spinal cord injury: a systematic review and meta-analysis.","authors":"Ehsan Jangholi, Seyed Danail Alizadeh, Farzin Farahbakhsh, Vali Baigi, Zahra Ghodsi, Pouya Mahdavi Sharif, Shahriar Ghashghaei, Mahkameh Abbaszadeh, Arman Zeinaddini Meymand, Zahra Eskandari, Vafa Rahimi-Movaghar","doi":"10.1038/s41394-024-00685-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Study design: </strong>A systematic review and meta-analysis OBJECTIVE: To determine the global frequency of osteomyelitis in individuals with spinal cord injury who have pressure injuries (SCI-PI).</p><p><strong>Methods: </strong>A comprehensive search on PubMed, EMBASE, Scopus, and the Web of Science has been conducted until November 2023. The Cochrane Handbook for Systematic Reviews was followed. Cohort and cross-sectional studies included SCI-PI participants who reported the frequency of osteomyelitis without language restriction. Data extraction was performed by four reviewers in two groups. We used the Newcastle-Ottawa Quality Assessment Scale for quality assessment. The Chi-squared and I<sup>2</sup> tests were applied to detect heterogeneity between studies. Also, a random-effects model was performed for the report data.</p><p><strong>Results: </strong>Ten out of 986 studies met our eligibility criteria, with 492 SCI-PI individuals. It was discovered that most SCIs were thoracolumbar injuries and male. There was a history of PI in more than half the patients. SCI was primarily caused by trauma. A meta-analysis revealed a significantly heterogeneous 43.0% osteomyelitis frequency. There was no evidence of publication bias. Subgroup analysis based on study quality revealed that the frequency of osteomyelitis in low-quality studies was 34.5%, whereas the frequency in high-quality research was 47.4%. Furthermore, the overall frequency of osteomyelitis was 29.0% in the subgroup analysis of research carried out in the USA.</p><p><strong>Conclusions: </strong>Our study highlights the significant burden of osteomyelitis among SCI-PI individuals. These findings underscore the pressing need for standardized diagnostic and management protocols to mitigate the morbidity associated with osteomyelitis in this vulnerable population.</p>","PeriodicalId":22079,"journal":{"name":"Spinal Cord Series and Cases","volume":"10 1","pages":"72"},"PeriodicalIF":0.7000,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11473765/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Spinal Cord Series and Cases","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1038/s41394-024-00685-8","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
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Abstract
Study design: A systematic review and meta-analysis OBJECTIVE: To determine the global frequency of osteomyelitis in individuals with spinal cord injury who have pressure injuries (SCI-PI).
Methods: A comprehensive search on PubMed, EMBASE, Scopus, and the Web of Science has been conducted until November 2023. The Cochrane Handbook for Systematic Reviews was followed. Cohort and cross-sectional studies included SCI-PI participants who reported the frequency of osteomyelitis without language restriction. Data extraction was performed by four reviewers in two groups. We used the Newcastle-Ottawa Quality Assessment Scale for quality assessment. The Chi-squared and I2 tests were applied to detect heterogeneity between studies. Also, a random-effects model was performed for the report data.
Results: Ten out of 986 studies met our eligibility criteria, with 492 SCI-PI individuals. It was discovered that most SCIs were thoracolumbar injuries and male. There was a history of PI in more than half the patients. SCI was primarily caused by trauma. A meta-analysis revealed a significantly heterogeneous 43.0% osteomyelitis frequency. There was no evidence of publication bias. Subgroup analysis based on study quality revealed that the frequency of osteomyelitis in low-quality studies was 34.5%, whereas the frequency in high-quality research was 47.4%. Furthermore, the overall frequency of osteomyelitis was 29.0% in the subgroup analysis of research carried out in the USA.
Conclusions: Our study highlights the significant burden of osteomyelitis among SCI-PI individuals. These findings underscore the pressing need for standardized diagnostic and management protocols to mitigate the morbidity associated with osteomyelitis in this vulnerable population.
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