Accuracy of Pressure Injury Risk Assessment Tools in Paediatrics: A Systematic Review and Network Meta-Analysis

IF 3.2 3区医学 Q1 NURSING

Journal of Clinical Nursing Pub Date : 2025-03-09 DOI:10.1111/jocn.17670

Shixia Lei, Hongyan Zhang, Chenlu Yuan, Xinrui Bai, Yusheng Mo, Yuxia Ma, Lin Han

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引用次数: 0

Abstract

Aim

To evaluate the accuracy of different pressure injury risk assessment tools in paediatrics and identify risk assessment tools with the best predictive performance.

Design

A systematic review and network meta-analysis.

Methods

Eight electronic databases, including PubMed, Embase, Web of Science, Cochrane Library, China Knowledge Resource Integrated Database, Weipu Database, Wanfang Database and Chinese Biomedical Database were comprehensively searched. The study was conducted using the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines 2020. Two researchers independently conducted article screening, data extraction and quality assessment. Statistical analysis was performed using R 4.3.1 and Stata 14.0.

Results

A total of 20 articles were included in this study, involving 4908 patients and 13 pressure injury risk assessment tools for children, of which 15 articles were included in the network meta-analysis. The results showed that the Paediatric Pressure Ulcer Prediction and Evaluation Tool (PPUPET) had the highest superiority index, with the relative sensitivity (0.7, 95% confidence interval, CI: 0.0–1.5) and the relative specificity (1.4, 95% CI: 0.7–1.8). The next was Braden-Q combined with the Glamorgan scale, with a superiority index of 7.08, a relative sensitivity of 1.1 (95% CI: 0.5–1.5) and a relative specificity of 1.3 (95% CI: 0.8–1.7).

Conclusions

This study suggested that the PPUPET can comprehensively evaluate medical device-related pressure injuries in children, the Braden-Q scale had a better predictive performance for children aged 21 days–8 years in general paediatric departments, and the Glamorgan scale was suitable in the Paediatric Intensive Care Unit.

Relevance to Clinical Practice

This review highlights that clinical practitioners should select appropriate assessment tools based on different departments and the age of children to accurately assess the risk of pressure injuries in children.

Patient or Public Contribution

No Patient or Public Contribution.

Protocol Registration

PROSPERO CRD42023470769. http://www.crd.york.ac.uk/PROSPERO/#recordDetails.

查看原文本刊更多论文

儿科压力损伤风险评估工具的准确性：系统回顾和网络荟萃分析。

目的：评价不同儿科压力损伤风险评估工具的准确性，找出预测效果最好的风险评估工具。设计：系统回顾和网络荟萃分析。方法：对PubMed、Embase、Web of Science、Cochrane Library、中国知识资源综合数据库、卫普数据库、万方数据库、中国生物医学数据库等8个电子数据库进行综合检索。该研究使用2020年系统评价和荟萃分析（PRISMA）指南的首选报告项目进行。两位研究者独立进行了文章筛选、数据提取和质量评估。采用r4.3.1和Stata 14.0进行统计学分析。结果：本研究共纳入20篇文章，涉及4908例患者和13种儿童压力损伤风险评估工具，其中15篇文章纳入网络meta分析。结果显示，小儿压疮预测与评估工具（puppet）的优势指数最高，相对敏感性为0.7,95%可信区间CI为0.0 ~ 1.5，相对特异性为1.4,95% CI为0.7 ~ 1.8。其次是Braden-Q联合Glamorgan评分法，其优势指数为7.08，相对敏感性为1.1 (95% CI: 0.5-1.5)，相对特异性为1.3 （95% CI: 0.8-1.7）。结论：本研究提示木偶能全面评价儿童医疗器械相关压力损伤，Braden-Q量表对普通儿科21天~ 8岁儿童有较好的预测效果，Glamorgan量表适用于儿科重症监护病房。与临床实践的相关性：本文综述强调临床医生应根据不同科室和儿童年龄选择合适的评估工具，准确评估儿童压力损伤的风险。患者或公众捐赠：无患者或公众捐赠。协议注册：PROSPERO CRD42023470769。http://www.crd.york.ac.uk/PROSPERO/ recordDetails。

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来源期刊

Journal of Clinical Nursing 医学-护理

CiteScore

6.40

自引率

2.40%

发文量

审稿时长

2 months

期刊介绍： The Journal of Clinical Nursing (JCN) is an international, peer reviewed, scientific journal that seeks to promote the development and exchange of knowledge that is directly relevant to all spheres of nursing practice. The primary aim is to promote a high standard of clinically related scholarship which advances and supports the practice and discipline of nursing. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, JCN seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Emphasis is placed on promoting critical debate on the art and science of nursing practice. JCN is essential reading for anyone involved in nursing practice, whether clinicians, researchers, educators, managers, policy makers, or students. The development of clinical practice and the changing patterns of inter-professional working are also central to JCN''s scope of interest. Contributions are welcomed from other health professionals on issues that have a direct impact on nursing practice. We publish high quality papers from across the methodological spectrum that make an important and novel contribution to the field of clinical nursing (regardless of where care is provided), and which demonstrate clinical application and international relevance.