The global burden of pressure ulcers among patients with spinal cord injury: a systematic review and meta-analysis

Abstract

Abstract Background Pressure ulcer, one of the common challenging public health problems affecting patient with spinal cord injury, is the formation of lesion and ulceration on the skin specially in the bony prominence areas. 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, the objective of this systematic review and meta-analysis was to estimate the global magnitude of pressure ulcers among patient with spinal cord injury. Methods PubMed, Scopus, Google Scholar, Africa journal online, PsycINFO and web-science were systematically searched online to retrieve related articles. The Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guideline was followed. The random-effects model was fitted to estimate the summary effect. To investigate heterogeneity across the included studies, I 2 test was employed. Publication bias was examined using funnel plot and Egger’s regression test statistic. All statistical analysis was done using STATA version 14 software for windows. Results Twenty-four studies which comprises of 600,078 participants were included in this meta-analysis. The global pooled magnitude of pressure ulcer 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). Conclusion This 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, policymakers (FMoH) and other concerned bodies need give special attention to reduce the magnitude of pressure ulcers in patient with spinal cord injury.