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Meta-Analysis
. 2020 May 29;21(1):334.
doi: 10.1186/s12891-020-03369-0.

The global burden of pressure ulcers among patients with spinal cord injury: a systematic review and meta-analysis

Wondimeneh Shibabaw Shiferaw  1 , Tadesse Yirga Akalu  2 , Henok Mulugeta  2 , Yared Asmare Aynalem  3
Affiliations
Meta-Analysis

The global burden of pressure ulcers among patients with spinal cord injury: a systematic review and meta-analysis

Wondimeneh Shibabaw Shiferaw et al. BMC Musculoskelet Disord. .

Abstract

Background: Pressure ulcers (PU), one of the common challenging public health problems affecting patient with spinal cord injury. PUs occurs over bony areas of the body where pressure and tissue distortion is greatest. It has a significant impact to the patient and health care system. Moreover, it has psychological, physical, social burden and decrease the quality of life (QoL) of patients. Despite its serious complications, limited evidence is available on the global magnitude of pressure ulcers among patient with spinal cord injury. Hence, this review and meta-analysis aimed to estimate the global magnitude of pressure ulcers among patient with spinal cord injury.

Methods: PubMed, Scopus, Google Scholar, African Journals Online, PsycINFO, and Web of Science were systematically searched to retrieve related articles. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guideline was followed. DerSimonian and Laird random-effects model was applied to obtain the pooled effect size. To investigate heterogeneity across the included studies, I2 test was employed. Publication bias was examined using funnel plot and Egger's regression test statistic. Sensitivity analysis was deployed to see the effect of a single study on the overall estimation. Analysis was done using STATA™ Version 14 software.

Results: A total of 24 studies which comprises of 600,078 participants were included in this study. The global pooled magnitude of pressure ulcers among patients with spinal cord injury was 32.36% (95% CI (28.21, 36.51%)). Based on the subgroup analysis, the highest magnitude of pressure ulcer was observed in Africa 41.19% (95% CI: 31.70, 52.18).

Conclusion: This systematic review and meta-analysis revealed that about one in three patients with spinal cord injury had pressure ulcers. This implies that the overall global magnitude of pressure ulcer is relatively high. Therefore, policy maker and other concerned body should be design country context- specific preventive strategies to reduce the burden of pressure ulcers in patients with spinal cord injury.

Keywords: Ethiopia; Meta-analysis; Pressure ulcers; Spinal cord injury; Systematic review.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA flowchart diagram of the study selection
Fig. 2
Fig. 2
The global pooled prevalence of PU in patients with SCI
Fig. 3
Fig. 3
Forest plot showing subgroup analysis by study design
Fig. 4
Fig. 4
Forest plot showing subgroup analysis by study continent
Fig. 5
Fig. 5
Funnel plot to test the presence of publication bias of the 24 studies
Fig. 6
Fig. 6
Result of sensitivity analysis of the 24 studies
See this image and copyright information in PMC

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