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儿童患者压力性损伤的发病率和患病率:一项系统评价和荟萃分析。

Incidence and prevalence of pressure injuries in children patients: A systematic review and meta-analysis.

作者信息

Zhang Hongyan, Ma Yuxia, Wang Qing, Zhang Xiujuan, Han Lin

机构信息

Department of Nursing, Gansu Provincial Hospital, Lanzhou City, Gansu Province, China.

Evidence-based Nursing Center, School of Nursing, Lanzhou University, Lanzhou City, Gansu Province, China.

出版信息

J Tissue Viability. 2022 Feb;31(1):142-151. doi: 10.1016/j.jtv.2021.07.003. Epub 2021 Jul 19.

Abstract

BACKGROUND

Pressure injuries presently has been a serious healthcare problem all over the world. Children were recognized as the high-risk population of pressure injuries in the latest prevention and treatment of pressure injuries clinical practice guideline. However, the estimates of incidence, and prevalence of pressure injuries in hospitalized children patients vary considerable in relevant published studies.

OBJECTIVE

To systematically quantify the incidence and prevalence of pressure injuries (PIs) in hospitalized children and the most affected PIs sites.

METHODS

A systematic review and meta-analysis was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines. Electronic databases searches of the Cochrane Library, Pubmed, Web of Science, Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, China Knowledge Resource Integrated Database (CNKI), Wanfang Database, Chinese Biomedical Database (CBM), and Weipu Database (VIP), and hand-search through references were conducted to find relevant articles. Studies were evaluated independently by two researchers and audited by a third researcher. The data were extracted and presented in tables. The risk of bias was assessed using Hoy's tool. The I statistic and random-effects model were used to assess the heterogeneity. Meta-regression analysis and subgroup analysis were conducted to examine between-study heterogeneity.

RESULTS

A total of 6, 672 articles were screened, and 30 studies with 251, 501 participants were ultimately included in this review. The pooled incidence of PIs for 3, 205 children was 13.5% (95% CI: 10.5-16.5); and the pooled prevalence of PIs for 4, 639 children was 12.2% (95% CI: 8.0-16.3). The most affected body sites were occiput, ears, and nose. Meta-regression and subgroup analysis showed that the inpatient ward, and region were the sources of heterogeneity.

CONCLUSIONS

The incidence and prevalence of PIs was significantly higher than the adults. Our discoveries recommended that healthcare givers ought to pay more consideration to diminish the happens of PIs. Additionally, more research may be needed to improve our understanding of the characteristics of PIs among children and to identify PIs risk factors to prevent and treat it in children effectively.

摘要

背景

目前,压疮已成为全球严重的医疗保健问题。在最新的压疮防治临床实践指南中,儿童被认定为压疮的高危人群。然而,在相关已发表的研究中,住院儿童患者压疮的发病率和患病率估计差异很大。

目的

系统量化住院儿童压疮(PIs)的发病率和患病率以及受影响最严重的PIs部位。

方法

根据系统评价和Meta分析的首选报告项目指南进行系统评价和Meta分析。通过电子数据库检索Cochrane图书馆、PubMed、科学网、Medline、Embase、护理及相关健康文献累积索引、中国知识资源总库(CNKI)、万方数据库、中国生物医学数据库(CBM)和维普数据库(VIP),并通过参考文献手工检索以查找相关文章。由两名研究人员独立评估研究,并由第三名研究人员审核。提取数据并以表格形式呈现。使用Hoy工具评估偏倚风险。采用I统计量和随机效应模型评估异质性。进行Meta回归分析和亚组分析以检验研究间的异质性。

结果

共筛选出6672篇文章,最终纳入30项研究,涉及251501名参与者。3205名儿童的PIs合并发病率为13.5%(95%CI:10.5 - 16.5);4639名儿童的PIs合并患病率为12.2%(95%CI:8.0 - 16.3)。受影响最严重的身体部位是枕部、耳朵和鼻子。Meta回归和亚组分析表明,住院病房和地区是异质性的来源。

结论

PIs的发病率和患病率显著高于成人。我们的研究结果建议医护人员应更加关注减少PIs的发生。此外,可能需要更多的研究来提高我们对儿童PIs特征的理解,并确定PIs的危险因素,以便有效地预防和治疗儿童PIs。

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