Abstract:
Background: Pressure 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.
Methods: PubMed, 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. Results: A 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).
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, 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.