Incidence and Risk Factors for Orthopedic Device-Related Pressure Injuries: A Systematic Review and Meta-Analysis

BACKGROUND:As orthopedic trauma increases, the resultant use of orthopedic devices and associated pressure injuries has increased. OBJECTIVE:This study aims to systematically evaluate the incidence and risk factors for orthopedic device-related pressure injuries. METHODS:A systematic review and meta-analysis was conducted by searching PubMed, Embase, Cochrane Library, Web of Science, ClNAHL, China National Knowledge Infrastructure, Wanfang Database, and Chinese BioMedical Literature Database from their inception until November 30, 2023. The population included adult orthopedic surgery patients aged 18 and older. Studies included case-control, cohort, or cross-sectional designs reporting risk factors, incidence, or predictors of orthopedic device-related pressure injuries published in Chinese or English. Exclusion criteria included unavailable full text, duplicate publications, reviews, animal studies, and conference abstracts. Two researchers independently screened the literature, extracted the data, and assessed the quality of the literature. RESULTS:A total of eight papers involving 3,783 patients were included. Meta-analysis showed that the incidence of orthopedic device-related pressure injuries was 12.0%. Significant risk factors included duration of device wear [OR 1.197, 95% Cl (1.025, 1.369), p = .016] and the length of stay [OR 1.144, 95% CI (1.096, 1.199), p < .001]. CONCLUSION:The duration of device wear and length of stay are key factors contributing to orthopedic device-related pressure injuries. Clinicians should actively monitor and manage these factors to reduce the risk of these injuries.