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医疗器械相关压力性损伤的发生率:一项荟萃分析。

Incidence of medical device-related pressure injuries: a meta-analysis.

机构信息

Department of ICU, The 305 Hospital of PLA, Jia13 Wenjin St, Beijing, 100017, China.

Department of General Surgery, Western Medical Branch of PLA General Hospital, Beijing, 100144, China.

出版信息

Eur J Med Res. 2024 Aug 19;29(1):425. doi: 10.1186/s40001-024-01986-2.

Abstract

BACKGROUND

Medical device-related pressure injures (MDRPIs) are common in critically ill patients and associated with negative clinical outcomes and elevated healthcare expenses. We aim to estimate worldwide incidence of MDRPI and explore associated factors through systemic review and meta-analysis.

METHODS

The PubMed, Web of Science, Cochrane Library, and Ovid EMBASE databases were systematically queried to identify relevant studies published from Jan 1, 2010 up until June 30, 2024. Studies were included if they provided data on the incidence or prevalence of MDRPI. Random-effect models were utilized to calculate the overall or domain-specific aggregated estimates of MDRPI. A meta-regression analysis was additionally performed to investigate the heterogeneity among studies.

RESULTS

We included 28 observational studies on 117,624 patients in the meta-analysis. The overall incidence of MDRPI was 19.3% (95% confidence interval (CI) 13.5-25.2%). The incidence of MDRPI in Europe, North America, Asia, South America, and Oceania was 17.3% (95% CI 12.7-21.9%), 3.6% (95% CI 0.0-8.5%), 21.9% (95% CI 14.3-29.6%), 48.3% (95% CI 20.8-75.7%), and 13.0% (95% CI 5.0-21.1%), respectively (p < 0.01). Multivariate meta-regressions revealed South America and special inpatient (critically ill patient, etc.) were independently associated with higher MDRPI incidence.

CONCLUSIONS

Nearly, 20% of the patients in ICU suffered from MDRPI. The incidence of MDRPI in underdeveloped regions is particularly concerning, highlighting the importance of focusing on measures to prevent it, in order to reduce the medical burden and enhance the quality of life for affected patients.

摘要

背景

医疗器械相关性压力损伤(MDRPI)在重症患者中较为常见,与负面临床结局和医疗费用增加相关。我们旨在通过系统综述和荟萃分析评估全球 MDRPI 的发生率,并探讨其相关因素。

方法

系统检索 PubMed、Web of Science、Cochrane 图书馆和 Ovid EMBASE 数据库,以确定 2010 年 1 月 1 日至 2024 年 6 月 30 日期间发表的相关研究。纳入研究需提供 MDRPI 发生率或患病率数据。采用随机效应模型计算 MDRPI 的总体或特定领域汇总估计值。此外,还进行了荟萃回归分析以探究研究间的异质性。

结果

我们将 28 项观察性研究纳入荟萃分析,共涉及 117624 例患者。MDRPI 的总体发生率为 19.3%(95%置信区间 13.5-25.2%)。欧洲、北美、亚洲、南美和大洋洲的 MDRPI 发生率分别为 17.3%(95%置信区间 12.7-21.9%)、3.6%(95%置信区间 0.0-8.5%)、21.9%(95%置信区间 14.3-29.6%)、48.3%(95%置信区间 20.8-75.7%)和 13.0%(95%置信区间 5.0-21.1%)(p<0.01)。多变量荟萃回归显示,南美和特殊住院患者(如重症患者等)与更高的 MDRPI 发生率独立相关。

结论

近 20%的 ICU 患者患有 MDRPI。欠发达地区 MDRPI 的发生率尤其令人担忧,这凸显了关注预防措施的重要性,以减轻医疗负担,提高受影响患者的生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5171/11331740/5f6408d6c381/40001_2024_1986_Fig1_HTML.jpg

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