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Meta-Analysis
. 2023 Jun 23;18(6):e0287326.
doi: 10.1371/journal.pone.0287326. eCollection 2023.

Risk factors for medical device-related pressure injury in ICU patients: A systematic review and meta-analysis

Ling Gou  1 , Zhiqin Zhang  1 , Yongde A  2
Affiliations
Meta-Analysis

Risk factors for medical device-related pressure injury in ICU patients: A systematic review and meta-analysis

Ling Gou et al. PLoS One. .

Abstract

Background: Medical device-related pressure injury (MDRPI) in intensive care unit (ICU) patients is a serious issue. We aimed to evaluate the risk factors for MDRPI associated with ICU patients through systematic review and meta-analysis, and provide insights into the clinical prevention of MDRPI.

Methods: We searched PubMed, Embase, Web of Science, China National Knowledge Infrastructure (CNKI), WanFang Database, and China BioMedical Literature Database (CBM) (from inception to January 2023) for studies that identified risk factors of MDRPI in ICU patients. In order to avoid the omission of relevant literature, we performed a secondary search of the above database on February 15, 2023. Meta-analysis was performed using Revman 5.3.

Results: Fifteen studies involving 4850 participants were selected to analyze risk factors for MDRPI in ICU patients. While conducting a meta-analysis, we used sensitivity analysis to ensure the reliability of the results for cases with significant heterogeneity among studies. When the source of heterogeneity cannot be determined, we only described the risk factor. The risk factors for MDRPI in ICU patients were elder age (OR = 1.06, 95% CI: 1.03-1.10), diabetes mellitus (OR = 3.20, 95% CI: 1.96-5.21), edema (OR = 3.62, 95% CI: 2.31-5.67), lower Braden scale score (OR = 1.22, 95%CI: 1.11-1.33), higher SOFA score (OR = 4.21, 95%CI: 2.38-7.47), higher APACHE II score (OR = 1.38, 95%CI: 1.15-1.64), longer usage time of medical devices (OR = 1.11, 95%CI: 1.05-1.19), use of vasoconstrictors (OR = 6.07, 95%CI: 3.15-11.69), surgery (OR = 4.36, 95% CI: 2.07-9.15), prone position (OR = 24.71, 95% CI: 7.34-83.15), and prone position ventilation (OR = 17.51, 95% CI: 5.86-52.36). Furthermore, we found that ICU patients who used subglottic suction catheters had a higher risk of MDRPI, whereas ICU patients with higher hemoglobin and serum albumin levels had a lower risk of MDRPI.

Conclusion: This study reported the risk factors for MDRPI in ICU patients. A comprehensive analysis of these risk factors will help to prevent and optimize interventions, thereby minimizing the occurrence of MDRPI.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow chart.
Fig 2
Fig 2. Meta-analyses for the association between age and MDRPI.
Fig 3
Fig 3. Meta-analyses for the association between diabetes and MDRPI.
Fig 4
Fig 4. Meta-analyses for the association between edema and MDRPI.
Fig 5
Fig 5. Meta-analyses for the association between Braden scale score and MDRPI.
Fig 6
Fig 6. Meta-analyses for the association between SOFA score and MDRPI.
Fig 7
Fig 7. Meta-analyses for the association between APACHE II score and MDRPI.
Fig 8
Fig 8. Meta-analyses for the association between usage time of medical devices and MDRPI.
Fig 9
Fig 9. Meta-analyses for the association between the use of vasoconstrictors and MDRPI.
Fig 10
Fig 10. Meta-analyses for the association between surgery and MDRPI.
Fig 11
Fig 11. Meta-analyses for the association between position and MDRPI.
Fig 12
Fig 12. Meta-analyses for the association between prone position ventilation and MDRPI.
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