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Annals of Medicine and Surgery (2012) May 2021Postoperative pressure ulcers are known as the most important quality indicators of intraoperative care that create critical and costly complications during hospital... (Review)
Review
BACKGROUND AND OBJECTIVE
Postoperative pressure ulcers are known as the most important quality indicators of intraoperative care that create critical and costly complications during hospital care. Accordingly, this study was performed to determine the risk factor for diabetes in postoperative pressure ulcers.
MATERIALS AND METHODS
The present study is a systematic review of PubMed, Scopus and the Web of Science databases with using standardized keywords of the performed English language articles between Jan 2010 to Jan 2020. The articles were searched independently by two related researchers to avoid possible biases. Then, all collected articles were reviewed, and articles with inclusion criteria were evaluated using a data collection table. It should be noted that the data were analyzed using STATA software version 11.1.
RESULTS
Overall, the results showed that 19724 patients were identified from 15 studies conducted in Asia (six), the America (four), Europe (four), and Australia (one) from 1989 to 2019. The results showed that patients with diabetes were more likely to experience surgery-related pressure ulcers than patients without diabetes (The odds ratio of 1.52; the 95% confidence interval: 1.25-1.85).
CONCLUSION
In general, patients with diabetes increased the risk of surgery-related pressure ulcers about 1.5 times more than others. Accordingly, the reduction of surgery-induced pressure ulcers should be more extensively considered in patients with diabetes.
PubMed: 33996066
DOI: 10.1016/j.amsu.2021.102336 -
Journal of Medical Internet Research Sep 2022Pressure injury is a common complication after a spinal cord injury. Long-term multidisciplinary follow-up is difficult after such patients have been discharged.... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Pressure injury is a common complication after a spinal cord injury. Long-term multidisciplinary follow-up is difficult after such patients have been discharged. Telemedicine promises to provide convenient and effective support for the prevention and treatment of pressure injury, but previous attempts to demonstrate that have produced inconsistent results.
OBJECTIVE
The aim of this study is to evaluate the effectiveness of telemedicine in preventing and treating pressure injury among community-dwelling patients with spinal cord injury, and determine which telemedicine form is more effective.
METHODS
This systematic review was performed according to the PRISMA-NMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Network Meta-Analysis) standards. Ten databases were searched to identify randomized controlled trials and quasi-experimental studies related to the effectiveness of telemedicine intervention in patients with spinal cord injury. Two researchers worked independently and blindly selected studies, extracted data, and assessed the risk of bias. The results were described as relative risk (RR) and weighted mean difference and 95% CI.
RESULTS
The 35 studies comprised 25 randomized controlled trials and 10 quasi-experimental studies involving 3131 patients. The results showed that telemedicine can significantly (P<.05) reduce the incidence of pressure injury (RR 0.24, 95% CI 0.14-0.41; P<.05; I=0%), promote faster healing (RR 0.73, 95% CI 0.62-0.85; P<.05; I=0%), and yield lower scores on the pressure ulcer scale of healing (weighted mean difference=-1.98, 95% CI -3.51 to -0.46; P<.05; I=0%). Cumulative ranking estimates showed that combining telemedicine with conventional intervention (93.5%) was the most effective approach.
CONCLUSIONS
Telemedicine is a feasible way to prevent pressure injury among patients with spinal cord injuries. It can decrease the incidence and severity of pressure injury and accelerate patients' healing without imposing economic burden. It is best used in tandem with other, more conventional interventions. Due to the limited quality and quantity of included studies, large-scale and well-designed randomized controlled trials are warranted.
Topics: Humans; Incidence; Independent Living; Pressure Ulcer; Spinal Cord Injuries; Telemedicine
PubMed: 36069842
DOI: 10.2196/37618 -
Machine learning-based prediction models for pressure injury: A systematic review and meta-analysis.International Wound Journal Dec 2023Despite the fact that machine learning (ML) algorithms to construct predictive models for pressure injury development are widely reported, the performance of the model... (Meta-Analysis)
Meta-Analysis Review
Despite the fact that machine learning (ML) algorithms to construct predictive models for pressure injury development are widely reported, the performance of the model remains unknown. The goal of the review was to systematically appraise the performance of ML models in predicting pressure injury. PubMed, Embase, Cochrane Library, Web of Science, CINAHL, Grey literature and other databases were systematically searched. Original journal papers were included which met the inclusion criteria. The methodological quality was assessed independently by two reviewers using the Prediction Model Risk of Bias Assessment Tool (PROBAST). Meta-analysis was performed with Metadisc software, with the area under the receiver operating characteristic curve, sensitivity and specificity as effect measures. Chi-squared and I tests were used to assess the heterogeneity. A total of 18 studies were included for the narrative review, and 14 of them were eligible for meta-analysis. The models achieved excellent pooled AUC of 0.94, sensitivity of 0.79 (95% CI [0.78-0.80]) and specificity of 0.87 (95% CI [0.88-0.87]). Meta-regressions did not provide evidence that model performance varied by data or model types. The present findings indicate that ML models show an outstanding performance in predicting pressure injury. However, good-quality studies should be conducted to verify our results and confirm the clinical value of ML in pressure injury development.
Topics: Humans; Pressure Ulcer; Sensitivity and Specificity; ROC Curve; Machine Learning; Software
PubMed: 37340520
DOI: 10.1111/iwj.14280 -
Wound Management & Prevention Sep 2021Smoking is a risk factor for many diseases. (Meta-Analysis)
Meta-Analysis
BACKGROUND
Smoking is a risk factor for many diseases.
PURPOSE
This study explored the relationship between current or past smoking and pressure injury (PI) risk through a systematic review and meta-analysis.
METHODS
The databases PubMed, Web of Science, and China National Knowledge Infrastructure were searched for the years between 2001 and 2020. Quality of evidence was estimated by the Newcastle-Ottawa Scale. The random effects model was applied to assess the odds ratios (OR) and 95% confidence intervals (CI); pooled adjusted OR and 95% CI, subgroup analysis, publication bias, sensitivity analyses, and meta-regression analysis were performed.
RESULTS
Fifteen (15) studies (12 retrospective and 3 prospective) comprising data on 11 304 patients were eligible for inclusion in the review. The meta-analysis demonstrated that smoking increased the risk of PI (OR = 1.498; 95% CI, 1.058-2.122), and the pooled adjusted OR (1.969) and 95% CI (1.406-2.757) confirmed this finding. Publication bias was not detected by funnel plot, Begg's test (P = .322), or Egger's test (P = .666). Subgroup analyses yielded the same observations in both retrospective (OR = 1.607; 95% CI, 1.043-2.475) and prospective (OR = 1.218; 95% CI, 0.735-2.017) studies. The results were consistent across sensitivity analyses (OR = 1.07; 95% CI, 1.043- 2.475). Relevant heterogeneity moderators were not identified by meta-regression analysis with PI incidence (P = .466), years of patient data included (P = .637), mean patient age (P = .650), and diabetes mellitus diagnosis (P = .509).
CONCLUSION
This study found that individuals who are current or formers smokers have an almost 1.5 times higher risk of PI development than do those who do not smoke.
Topics: Humans; Odds Ratio; Prospective Studies; Retrospective Studies; Risk Factors; Smoking; Pressure Ulcer
PubMed: 34473642
DOI: No ID Found -
Journal of Tissue Viability May 2023The aim of this network meta-analysis is to analyze the difference in therapeutic effects between moist dressings and traditional dressings in the treatment of pressure... (Meta-Analysis)
Meta-Analysis Review
AIMS
The aim of this network meta-analysis is to analyze the difference in therapeutic effects between moist dressings and traditional dressings in the treatment of pressure injury (PI), explore the healing, healing time, direct cost, and number of dressing changes of different moist dressings for the management of pressure injuries.
BACKGROUND
The incidence of pressure injury is high and the burden of disease is high, but there is no consensus on how to choose moist dressing treatment.
DESIGN
A systematic review with network meta-analysis was performed.
DATA SOURCES
We searched the Chinese Biomedicine Literature Database and China National Knowledge Infrastructure, Wanfang Database, VIP database, PubMed, Web of Science, EMBASE.com, CENTRAL (Cochrane Central Register of Controlled Trials) and CINAHL to obtain randomized controlled trials (RCTs) on the treatment of PI with moist dressings.
REVIEW METHODS
R studio software and Stata 16.0 software were used to compare different moist dressings and traditional dressings.
RESULTS
41 RCTs of moist dressings in the treatment of PI were included. A total of seven kinds of moist dressings, Vaseline gauze and traditional gauze dressing were involved. All RCTs were at a medium to high risk of bias. Overall, moist dressings had more advantages than traditional dressings in terms of various outcome indicators.
CONCLUSION
The effect of moist dressings in treating PI is more advantageous than traditional dressings. However, in terms of direct cost and the number of dressings changes, more research is needed to improve the credibility of the network meta-analysis. The results of the network meta-analysis show that the silver ion dressing and alginate dressing are the best choices in the treatment of PI.
NO PATIENT OR PUBLIC CONTRIBUTION
This study is a network meta-analysis, which does not require the participation of patients and the public.
Topics: Humans; Pressure Ulcer; Network Meta-Analysis; Bandages; Wound Healing; Surgical Wound Infection
PubMed: 37012120
DOI: 10.1016/j.jtv.2023.03.003 -
Revista Latino-americana de Enfermagem 2023to map the instruments for risk assessment of pressure ulcers in adults in critical situation in intensive care units; identify performance indicators of the instrument,... (Review)
Review
OBJECTIVE
to map the instruments for risk assessment of pressure ulcers in adults in critical situation in intensive care units; identify performance indicators of the instrument, and the appreciation of users regarding the instruments' use/limitations.
METHOD
a scoping review. We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews in the writing of the study. We carried out the searches in the EBSCOhost search tool for 8 databases, resulting in 1846 studies, of which 22 studies compose the sample.
RESULTS
we identified two big instrument groups: generalist [Braden, Braden (ALB), Emina, Norton-MI, RAPS, and Waterlow]; and specific (CALCULATE, Cubbin & Jackson, EVARUCI, RAPS-ICU, Song & Choi, Suriaidi and Sanada, and COMHON index). Regarding the predictive value, EVARUCI and CALCULATE presented better results for performance indicators. Concerning appreciation/limitations indicated by users, we highlight the CALCULATE scale, followed by EVARUCI and RAPS-ICU, although they still need future adjustments.
CONCLUSION
the mapping of the literature showed that the evidence is sufficient to indicate one or more instruments for the risk assessment of pressure ulcers for adults in critical situation in intensive care units. (1) The risk assessment instrument must be applied to the patient's specificities. (2) The instruments are divided into two groups: generalist and specific. (3) The EVARUCI and CALCULATE instruments presented better results. (4) The EVARACI presented better results in terms of performance indicators. (5) The CALCULATE highlights itself for being recent scale, appropriate, simple, and easy to use.
Topics: Humans; Adult; Pressure Ulcer; Risk Assessment; Intensive Care Units
PubMed: 37820213
DOI: 10.1590/1518-8345.6659.3983 -
Journal of Tissue Viability Aug 2021Coronavirus disease 2019 (COVID-19) is causing a rapid and tragic health emergency worldwide. Because of the particularity of COVID-19, people are at a high risk of...
BACKGROUND
Coronavirus disease 2019 (COVID-19) is causing a rapid and tragic health emergency worldwide. Because of the particularity of COVID-19, people are at a high risk of pressure injuries during the prevention and treatment process of COVID-19.
OBJECTIVES
This systematic review aimed to summarize the pressure injuries caused by COVID-19 and the corresponding preventive measures and treatments.
METHODS
This systematic review was according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. PubMed, Web of science and CNKI (Chinese) were searched for studies on pressure injuries caused by COVID-19 published up to August 4, 2020. The quality of included studies was assessed by the Newcastle-Ottawa Quality Assessment Scale (NOS) and the CARE guidelines.
RESULTS
The data were extracted from 16 studies involving 7,696 participants in 7 countries. All studies were published in 2020. There are two main types of pressure injuries caused by the COVID-19: 1) Pressure injuries that caused by protective equipment (masks, goggles and face shield, etc.) in the prevention process; 2) pressure injuries caused by prolonged prone position in the therapy process.
CONCLUSIONS
In this systematic review, the included studies showed that wearing protective equipment for a long time and long-term prone positioning with mechanical ventilation will cause pressure injuries in the oppressed area. Foam dressing may need to be prioritized in the prevention of medical device related pressure injuries. The prevention of pressure injuries should be our particular attention in the course of clinical treatment and nursing.
Topics: COVID-19; Humans; Pandemics; Personal Protective Equipment; Pressure Ulcer; Respiration, Artificial; Risk Factors; SARS-CoV-2
PubMed: 33895045
DOI: 10.1016/j.jtv.2021.04.002 -
Journal of Tissue Viability Feb 2022Pressure 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... (Meta-Analysis)
Meta-Analysis
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.
Topics: Adult; Child; Humans; China; Incidence; Prevalence; Risk Factors; Pressure Ulcer
PubMed: 34312030
DOI: 10.1016/j.jtv.2021.07.003 -
Nursing Open Sep 2023To investigate the effectiveness of different dressings on pressure injuries and screen the dressings for efficacy. (Meta-Analysis)
Meta-Analysis
AIM
To investigate the effectiveness of different dressings on pressure injuries and screen the dressings for efficacy.
DESIGN
Systematic review and network meta-analysis.
METHODS
Articles published from several electronic databases and other resources were selected. Two reviewers independently selected studies, extracted data and assessed the quality of selected studies.
RESULTS
Twenty-five studies that contained data on moist dressings (hydrocolloidal dressing, foam dressing, silver ion dressing, biological wound dressing, hydrogel dressing, polymeric membrane dressing) and sterile gauze dressings (traditional gauze dressings) were included. All RCTs were at a medium to high risk of bias. Moist dressings were found to be more advantageous than the traditional dressings. Hydrocolloid dressings [RR = 1.38, 95% CI (1.18, 1.60)] showed a higher cure rate than sterile gauze dressing and foam dressings [RR = 1.37, 95% CI (1.16, 1.61)]. Silver ion dressings [RR = l.37, 95% CI (1.08, 1. 73)] showed a higher cure rate than sterile gauze dressings. Sterile gauze dressing dressings [RR = 0.51, 95% CI (0.44, 0.78)] showed a lower cure rate compared with polymeric membrane dressings; whereas Sterile gauze dressing dressings [RR = 0.80, 95% CI (0.47, 1.37)] had a lower cure rate compared to biological wound dressings. Foam and hydrocolloid dressings were associated with the least healing time. Few dressing changes were required for moist dressings.
Topics: Humans; Bandages, Hydrocolloid; Crush Injuries; Network Meta-Analysis; Polymers; Pressure Ulcer; Silver; Wound Healing
PubMed: 37386783
DOI: 10.1002/nop2.1867 -
Nursing Open Mar 2023To summarize the use of machine learning (ML) for hospital-acquired pressure injury (HAPI) prediction and to systematically assess the performance and construction... (Review)
Review
AIMS AND OBJECTIVES
To summarize the use of machine learning (ML) for hospital-acquired pressure injury (HAPI) prediction and to systematically assess the performance and construction process of ML models to provide references for establishing high-quality ML predictive models.
BACKGROUND
As an adverse event, HAPI seriously affects patient prognosis and quality of life, and causes unnecessary medical investment. At present, the performance of various scales used to predict HAPIs is still unsatisfactory. As a new statistical tool, ML has been applied to predict HAPIs. However, its performance has varied in different studies; moreover, some deficiencies in the model construction process were observed in each study.
DESIGN
Systematic review.
METHODS
Relevant articles published between 2010-2021 were identified in the PubMed, Web of Science, Scopus, Embase and CINHAL databases. Study selection was performed in accordance with the preferred reporting items for systematic reviews and meta-analysis guidelines. The quality of the included articles was assessed using the prediction model risk of bias assessment tool.
RESULTS
Twenty-three studies out of 1793 articles were considered in this systematic review. The sample size of each study ranged from 149-75353; the prevalence of pressure injuries ranged from 0.5%-49.8%. ML showed good performance for HAPI prediction. However, some deficiencies were observed in terms of data management, data pre-processing and model validation.
CONCLUSIONS
ML, as a powerful decision-making assistance tool, is helpful for the prediction of HAPIs. However, existing studies have been insufficient in terms of data management, data pre-processing and model validation. Future studies should address these issues to establish ML models for HAPI prediction that can be widely used in clinical practice.
RELEVANCE TO CLINICAL PRACTICE
This review highlights that ML is helpful in predicting HAPI; however, in the process of data management, data pre-processing and model validation, some deficiencies still need to be addressed. The ultimate goal of integrating ML into HAPI prediction is to develop a practical clinical decision-making tool. A complete and rigorous model construction process should be followed in future studies to develop high-quality ML models that can be applied in clinical practice.
Topics: Humans; Pressure Ulcer; Quality of Life; Prognosis; Machine Learning; Hospitals
PubMed: 36310417
DOI: 10.1002/nop2.1429