Prevalence and factors associated with pressure injury in patients undergoing open heart surgery: A systematic review and meta-analysis

Abstract

Pressure injuries (PIs) are one of the major and costliest medical problems with severe implications for patients. Cardiovascular surgery patients are at the higher risk of developing surgery-related PIs. So this study was conducted with the aim of investigating the prevalence and factors associated with PIs in patients undergoing open heart surgery. We identified articles through electronic databases such as Web of Science, Scopus, PubMed, ProQuest; and Persian Databases: SID, Magiran and Irandoc without restriction on language or publication period (from inception through June 2022). Finally, 17 studies that fulfilled eligibility criteria were included in final systematic review and meta-analysis. Data analyses were conducted using STATA version 14. The pooled prevalence of PI in patients undergoing open heart surgery was 24.06% (95% CI: 17.85–30.27). High heterogeneity was observed across the included studies (I2 = 96.0, P < 0.000). The prevalence by gender was reported as 25.19% (95% CI: 13.45–36.93) in men and 33.36% (95 CI%: 19.99–46.74) in women. The result showed there was statistically significant association between PI and Female sex (Pooled Est: 1.551, 95% CI: 1.199–2.006, z = 3.345, P = 0.001), diabetes (Pooled Est: 1.985, 95% CI: 1.383–2.849, z = 3.719, P = 0.000), advanced age (SMD: 0.33 years; 95% CI: 0.09–0.57), Duration of surgery (SMD: 0.47; 95% CI: 0.19–0.75) and preoperative serum albumin level (SMD: 0.56; 95% CI: 0.14–0.98). The relatively high PIs incidence among patients undergoing open heart surgery suggests that typical PI prevention methods are insufficient for this population. Targeted prevention measures must be developed and implemented.