The frequency of osteomyelitis after pressure injury in spinal cord injury: a systematic review and meta-analysis.

IF 0.7 Q4 CLINICAL NEUROLOGY
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
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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.

脊髓损伤压迫伤后骨髓炎的发生频率:系统回顾和荟萃分析。
研究设计:系统综述和荟萃分析 目的:确定脊髓损伤压迫伤(SCI-PI)患者骨髓炎的全球发病率:方法:对 PubMed、EMBASE、Scopus 和 Web of Science 进行了全面检索,检索期至 2023 年 11 月。检索遵循《Cochrane 系统综述手册》。队列研究和横断面研究纳入了报告骨髓炎发生频率的 SCI-PI 参与者,没有语言限制。数据提取由四位审稿人分两组进行。我们采用纽卡斯尔-渥太华质量评估量表进行质量评估。采用Chi-squared和I2检验来检测研究之间的异质性。此外,我们还对报告数据采用了随机效应模型:在 986 项研究中,有 10 项符合我们的资格标准,共涉及 492 名 SCI-PI 患者。研究发现,大多数 SCI 为胸腰椎损伤,且多为男性。半数以上的患者有 PI 病史。SCI 主要由外伤引起。一项荟萃分析显示,骨髓炎的发生率为 43.0%,差异很大。没有证据表明存在发表偏倚。基于研究质量的分组分析显示,低质量研究中骨髓炎的发生率为34.5%,而高质量研究中骨髓炎的发生率为47.4%。此外,在对美国进行的研究进行的分组分析中,骨髓炎的总体发生率为29.0%:我们的研究凸显了骨髓炎给 SCI-PI 患者带来的沉重负担。这些研究结果突出表明,迫切需要制定标准化的诊断和管理方案,以降低骨髓炎在这一弱势群体中的发病率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Spinal Cord Series and Cases
Spinal Cord Series and Cases Medicine-Neurology (clinical)
CiteScore
2.20
自引率
8.30%
发文量
92
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