Abstract
BackgroundPressure ulcers (PU), one of the common challenging public health problems affecting patient with spinal cord injury. PUs occurs over bony areas of the body where pressure and tissue distortion is greatest. It has a significant impact to the patient and health care system. Moreover, it has psychological, physical, social burden and decrease the quality of life (QoL) of patients. Despite its serious complications, limited evidence is available on the global magnitude of pressure ulcers among patient with spinal cord injury. Hence, this review and meta-analysis aimed to estimate the global magnitude of pressure ulcers among patient with spinal cord injury.MethodsPubMed, Scopus, Google Scholar, African Journals Online, PsycINFO, and Web of Science were systematically searched to retrieve related articles. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guideline was followed. DerSimonian and Laird random-effects model was applied to obtain the pooled effect size. To investigate heterogeneity across the included studies, I2 test was employed. Publication bias was examined using funnel plot and Egger’s regression test statistic. Sensitivity analysis was deployed to see the effect of a single study on the overall estimation. Analysis was done using STATA™ Version 14 software.ResultsA total of 24 studies which comprises of 600,078 participants were included in this study. The global pooled magnitude of pressure ulcers among patients with spinal cord injury was 32.36% (95% CI (28.21, 36.51%)). Based on the subgroup analysis, the highest magnitude of pressure ulcer was observed in Africa 41.19% (95% CI: 31.70, 52.18).ConclusionThis systematic review and meta-analysis revealed that about one in three patients with spinal cord injury had pressure ulcers. This implies that the overall global magnitude of pressure ulcer is relatively high. Therefore, policy maker and other concerned body should be design country context- specific preventive strategies to reduce the burden of pressure ulcers in patients with spinal cord injury.
Highlights
Pressure ulcers (PU), one of the common challenging public health problems affecting patient with spinal cord injury
According to the National Pressure Ulcer Advisory Panel (NPUAP) consensus development conference, pressure ulcers are classified based on severity from suspected deep tissue injury through unstageable, with suspected deep tissue injury representing the earliest stage of pressure ulcer formation, and unstageable is defined as “full thickness tissue loss in which the base of the ulcer is covered by slough and/or eschar in the wound bed” [10]
The present findings revealed that the global pooled prevalence of PU in patients with Spinal cord injury (SCI) was 32.36%
Summary
Pressure ulcers (PU), one of the common challenging public health problems affecting patient with spinal cord injury. It has a significant impact to the patient and health care system. It has psychological, physical, social burden and decrease the quality of life (QoL) of patients. Despite its serious complications, limited evidence is available on the global magnitude of pressure ulcers among patient with spinal cord injury. Spinal cord injury (SCI) is a life-threatening and debilitating injury with tremendous immediate and long-term extensive impact on the medical, social, psychological and economic aspects of clients, their caregivers and the society [1,2,3]. According to the NPUAP consensus development conference, pressure ulcers are classified based on severity from suspected deep tissue injury through unstageable, with suspected deep tissue injury representing the earliest stage of pressure ulcer formation, and unstageable is defined as “full thickness tissue loss in which the base of the ulcer is covered by slough (yellow, tan, gray, green, or brown) and/or eschar (tan, brown, or black) in the wound bed” [10]
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