Li Jialu, Qian Qiuxia, Nan Jinhan, Li Wenyuan, Zhang Tong, Zhang Hongyan, Ma Yuxia, Han Lin
Department of Nursing, School of Nursing, Lanzhou University, Lanzhou, Gansu, China.
J Vasc Access. 2025 Apr 23:11297298251319824. doi: 10.1177/11297298251319824.
Medical adhesive-related skin injury (MARSI) is a significant but underreported complication, particularly in cancer patients with peripherally inserted central catheters (PICC). This systematic review and meta-analysis aimed to estimate the prevalence of MARSI and identify key risk factors in this patient population.
A systematic search of PubMed, Embase, the Cochrane Library, CNKI, Wanfang, and VIP was conducted to identify studies reporting MARSI prevalence and risk factors in cancer patients with PICC. Pooled prevalence estimates and odds ratios (ORs) for risk factors were calculated using a random-effects model. Heterogeneity was assessed using the statistic, and subgroup analyses were performed to explore potential sources of heterogeneity. Publication bias was assessed using funnel plots and Egger's test.
A total of 20 studies met the inclusion criteria, encompassing 8411 patients. The pooled prevalence of MARSI was 22% (95% CI: 18-26), with substantial heterogeneity across studies ( = 96.3%). Subgroup analysis revealed that retrospective studies reported higher prevalence (25%) compared to prospective studies (16%). Key risk factors included advanced age (OR: 2.593, 95% CI: 1.322-5.089), higher BMI (OR: 2.927, 95% CI: 2.029-4.223), pre-existing skin conditions (OR: 2.487, 95% CI: 1.693-3.650), and the use of transparent film dressings (OR: 3.228, 95% CI: 2.086-5.001). Funnel plot and Egger's test showed no significant publication bias.
MARSI is prevalent in cancer patients with PICC. Modifiable risk factors should guide prevention strategies, including careful adhesive selection and regular skin assessments to improve patient outcomes.
医用胶粘剂相关皮肤损伤（MARSI）是一种严重但报告不足的并发症，尤其是在接受外周静脉穿刺中心静脉置管（PICC）的癌症患者中。本系统评价和荟萃分析旨在估计MARSI的患病率，并确定该患者群体中的关键危险因素。
对PubMed、Embase、Cochrane图书馆、中国知网、万方数据和维普资讯进行系统检索，以识别报告接受PICC的癌症患者中MARSI患病率和危险因素的研究。使用随机效应模型计算危险因素的合并患病率估计值和比值比（OR）。使用统计量评估异质性，并进行亚组分析以探索异质性的潜在来源。使用漏斗图和Egger检验评估发表偏倚。
共有20项研究符合纳入标准，涉及8411例患者。MARSI的合并患病率为22%（95%CI：18 - 26），各研究间存在显著异质性（ = 96.3%）。亚组分析显示，回顾性研究报告的患病率（25%）高于前瞻性研究（16%）。关键危险因素包括高龄（OR：2.593，95%CI：1.322 - 5.089）、较高的体重指数（BMI）（OR：2.927，95%CI：2.029 - 4.223）、既往皮肤疾病（OR：2.487，95%CI：1.693 - 3.650）以及使用透明薄膜敷料（OR：3.228，95%CI：2.086 - 5.001）。漏斗图和Egger检验显示无显著发表偏倚。
MARSI在接受PICC的癌症患者中很常见。可改变的危险因素应指导预防策略，包括谨慎选择胶粘剂和定期进行皮肤评估，以改善患者预后。
