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

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.

Effects of different dressings in the prevention of facial skin pressure injury related to non‐invasive ventilation: Systematic review and network meta‐analysis

“… 1 , 2 MDRPI accounts for 29.0% to 34.5% of hospital‐acquired pressure injuries. 3 , 4 Non‐invasive ventilation is the equipment of choice for the treatment of acute respiratory failure, which can efficiently enhance lung ventilation, alleviate respiratory muscle fatigue and rectify respiratory failure. 5 , 6 , 7 Multiple studies 8 , 9 , 10 have shown that patients using non‐invasive ventilation need to wear nasal masks or oronasal masks for a long time, which increases the risk of pressure damage in the region of facial bone prominence.…”