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Abstract：
The objective of this evidence-based review was to explore whether the evidence supports the use of nutritional supplements in pressure ulcer (PU) prevention strategies. Several electronic databases, including Ovid MEDLINE (1946 to May week 32 019), Ovid EMBASE (1947 to May 28, 2019), EBSCO CINAHL (until June 13, 2019), Scopus (until July 9, 2019), and the Web of Science (until June 13, 2019) were searched. No limitation was placed on the year of publication. Studies considered for inclusion were those with adult populations, and only English language texts with available full text were reviewed. AMSTAR (a measurement tool to assess systematic reviews) was used to evaluate the quality of the studies included in the systematic review. The Oxford Centre for Evidence-Based Medicine (OCEBM) 2011 Levels of Evidence was used to assess the level of evidence. Appraisal of Guidelines for Research and Evaluation Instrument (AGREE II) was used to assess guideline article, and Appraisal tool for Cross-Sectional Studies (AXIS) was also used for cross-sectional studies. The search identified 1761 studies. After the application of inclusion and exclusion criteria, 24 studies were retained of various designs, including 10 systematic reviews, five clinical reviews, three randomised controlled trials, two observational studies, one quasi-experimental study, one cross-sectional study, one cohort study, and one Clinical Guideline. Two were rated as high-quality reviews, 14 were rated as moderate-quality reviews, five were rated as low-quality reviews, and three were rated as critically low-quality reviews. The majority of the reviewed studies were of low-to-moderate quality because of biases in the study design and incomplete data reporting, which did not fulfil the reporting criteria of the appraisal tools. However, the majority of the studies showed a reduction in PU incidence after nutritional supplement though not significant. Whether the use of pharmacological appraisal tools to assess non-pharmacological studies is appropriate is unclear. Regardless of the low-to-moderate quality of the studies in this review, nutritional supplements appear to play a role in PU prevention.
摘要：
这项基于证据的审查的目的是探索证据是否支持在压疮（PU）预防策略中使用营养补充剂。几个电子数据库，包括OvidMEDLINE(1946年至5月第32019周)，OvidEMBASE（1947年至2019年5月28日），EBSCOCINAHL（至2019年6月13日），Scopus（截至2019年7月9日），和WebofScience（截至2019年6月13日）进行了搜索。对出版年份没有限制。考虑纳入的研究是成年人群的研究，并且仅审查了具有可用全文的英语文本。使用AMSTAR（一种评估系统评价的测量工具）来评估系统评价中纳入的研究的质量。牛津循证医学中心（OCEBM）2011年证据水平用于评估证据水平。评估研究和评估工具指南(AGREEII)用于评估指南文章，横断面研究的评估工具（AXIS）也用于横断面研究。搜索确定了1761项研究。在应用纳入和排除标准后，24项研究保留了各种设计，包括10项系统评价,五次临床回顾，三项随机对照试验，两项观察性研究，一项准实验研究，一项横断面研究，一项队列研究，和一个临床指南。两个被评为高质量的评论，14篇被评为中等质量评论，五篇被评为低质量评论，三个被评为严重低质量审查。由于研究设计中的偏见和不完整的数据报告，大多数审查的研究质量都是低到中等的。不符合评估工具的报告标准。然而,大多数研究表明，营养补充后PU的发病率降低，但并不显著。使用药理学评估工具评估非药理学研究是否合适尚不清楚。无论这篇综述中的研究质量如何，营养补充剂似乎在预防PU中发挥作用。
