Incidence of pressure injuries in patients with spinal cord injury: A systematic review and meta-analysis

IF 2.4 3区医学 Q2 DERMATOLOGY

Journal of tissue viability Pub Date : 2025-03-03 DOI:10.1016/j.jtv.2025.100881

Jie Xu , Yanxia Jiao , Ning Wang , Xinyue Xu , Limei Yang , Lin Han , Lin Lv

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引用次数: 0

Abstract

Objective

To systematically evaluate the incidence of pressure injuries (PIs) in patients with spinal cord injury (SCI) and to provide a basis for preventing and treating PIs.

Methods

A systematic review and meta-analysis were performed according to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. Electronic databases such as PubMed, Embase, Cochrane Library, Web of Science, China Knowledge Resource Integrated Database (CNKI), Wan-fang Database, Weipu Database (VIP), and the China Biomedical Database (CBM) were searched to collect cross-sectional and cohort studies related to PIs in SCI patients. All electronic literature sources were searched for relevant articles from inception to July 2024. Studies were independently assessed by two researchers and reviewed by a third. Data were extracted and presented in tabular form. The risk of bias was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist and the Agency for Healthcare Quality and Research (AHRQ) Cross-Sectional Study Evaluation Criteria. All data were analysed using Stata 16.0. The I² statistics and random effects models were used to determine heterogeneity, and results were expressed as incidence with 95 % confidence intervals (CI).

Results

11,754 articles were screened, and 35 studies involving 150,391 patients were finally included. The combined incidence of PIs in SCI patients was 28.8 % (95%CI: 24.2 to 33.4). For different genders, the incidence of PIs in male SCI patients was 29.2 % (95 % CI: 20.4 to 38.1), while for female SCI patients, it was 25.2 % (95 % CI: 16.1 to 34.3). The PI incidence rate in patients with SCI was 33.9 % (95 % CI: 27.1 to 40.7) before 2005, 29.4 % (95 % CI: 19.1 to 39.7) from 2006 to 2015, and 27.1 % (95 % CI: 20.8 to 33.3) from 2016 to 2024. According to regional distribution data by country, the combined incidence of PIs in SCI patients was 34.3 % (95 % CI: 21.0 to 47.6) in European countries, 20.9 % (95 % CI: 12.8 to 28.9) in Asian countries, 43.3 % (95 % CI: 16.5 to 70.1) in African countries, 25.0 % (95 % CI: 15.9 to 34.0) in North American countries, and 65.3 % (95 % CI: 55.9–74.7) in South American countries. In 12 studies that reported the anatomical location of PIs in patients with SCI, 1113 patients developed 1836 PIs. The sacrococcygeal region had the highest number of these injuries, totalling 521 (28.8 %), followed by the sciatic tuberosity, with 233 (12.9 %), then, the heel, with 221 (12.3 %).

Conclusion

The study's results showed an overall incidence of PIs in patients with SCI of 28.8 %, significantly exceeding the average incidence rate in adults. We found that the incidence of PIs was higher in men than in women in patients with SCI. Therefore, clinical care staff needs to adopt effective preventive and therapeutic measures and strategies to reduce the occurrence of PIs. Additionally, the risk factors for PIs in patients with SCI can be further investigated to prevent and treat PIs effectively.

查看原文本刊更多论文

脊髓损伤患者的压伤发生率：系统回顾和荟萃分析。

目的：系统评价脊髓损伤（SCI）患者压迫性损伤（PIs）的发生率，为脊髓损伤的防治提供依据。方法：根据系统评价和荟萃分析首选报告项目（PRISMA）指南进行系统评价和荟萃分析。检索PubMed、Embase、Cochrane Library、Web of Science、中国知识资源综合数据库（CNKI）、万方数据库、唯普数据库（VIP）和中国生物医学数据库（CBM）等电子数据库，收集与SCI患者pi相关的横断面和队列研究。从成立到2024年7月，检索了所有电子文献来源的相关文章。研究由两名研究人员独立评估，并由第三名研究人员进行审查。提取数据并以表格形式呈现。偏倚风险采用乔安娜布里格斯研究所（JBI）关键评估清单和医疗质量与研究机构（AHRQ）横断面研究评估标准进行评估。所有数据采用Stata 16.0进行分析。采用I2统计量和随机效应模型确定异质性，结果以95%置信区间（CI）的发生率表示。结果：共筛选11,754篇文章，最终纳入35项研究，涉及150,391例患者。脊髓损伤患者pi的总发生率为28.8% （95%CI: 24.2 ~ 33.4）。不同性别间，男性SCI患者pi发生率为29.2% (95% CI: 20.4 ~ 38.1)，女性SCI患者pi发生率为25.2% （95% CI: 16.1 ~ 34.3）。脊髓损伤患者PI发病率2005年前为33.9% (95% CI: 27.1 ~ 40.7)， 2006 ~ 2015年为29.4% (95% CI: 19.1 ~ 39.7)， 2016 ~ 2024年为27.1% （95% CI: 20.8 ~ 33.3）。根据各国的区域分布数据，SCI患者的pi综合发生率在欧洲国家为34.3% (95% CI: 21.0 ~ 47.6)，亚洲国家为20.9% (95% CI: 12.8 ~ 28.9)，非洲国家为43.3% (95% CI: 16.5 ~ 70.1)，北美国家为25.0% (95% CI: 15.9 ~ 34.0)，南美国家为65.3% （95% CI: 55.9 ~ 74.7）。在12项报道脊髓损伤患者pi解剖位置的研究中，有1113例患者出现了1836例pi。骶尾骨区损伤最多，共521例（28.8%），其次是坐骨粗隆，233例（12.9%），然后是足跟，221例（12.3%）。结论：本研究结果显示脊髓损伤患者pi的总体发生率为28.8%，明显超过成人的平均发生率。我们发现脊髓损伤患者中男性的pi发生率高于女性。因此，临床护理人员需要采取有效的预防和治疗措施和策略来减少pi的发生。进一步研究脊髓损伤患者发生PIs的危险因素，有效预防和治疗PIs。

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

Journal of tissue viability DERMATOLOGY-NURSING

CiteScore

3.80

自引率

16.00%

发文量

110

审稿时长

>12 weeks

期刊介绍： The Journal of Tissue Viability is the official publication of the Tissue Viability Society and is a quarterly journal concerned with all aspects of the occurrence and treatment of wounds, ulcers and pressure sores including patient care, pain, nutrition, wound healing, research, prevention, mobility, social problems and management. The Journal particularly encourages papers covering skin and skin wounds but will consider articles that discuss injury in any tissue. Articles that stress the multi-professional nature of tissue viability are especially welcome. We seek to encourage new authors as well as well-established contributors to the field - one aim of the journal is to enable all participants in tissue viability to share information with colleagues.