背景:在几项研究中已经建立了体重过轻和压力伤害(PI)之间的关联。然而,缺乏精心设计的研究来调查超重和肥胖与这些伤害之间的联系。
目的:本荟萃分析旨在调查成年住院患者体重指数(BMI)与PI风险之间的剂量-反应关系。
方法:PubMed,WebofScience,和MEDLINE数据库从开始到2024年5月进行了搜索。该研究包括至少三个BMI类别的观察性文章。BMI被定义为体重不足,正常体重,超重,和病态肥胖的荟萃分析。使用受限三次样条模型研究了住院成年人BMI与PI风险之间的非线性关系。使用分数多项式建模。
结果:11篇报告至少3类BMI符合纳入标准的文章,包括31,389名参与者。与体重正常的患者相比,那些体重不足的人,肥胖,病态肥胖表现出增加的PI风险,赔率比为1.70(95CI:1.50-1.91),1.12(95CI:1.02-1.24),1.70(95CI:1.13-2.55),分别。建立了PI风险与BMI之间关系的J形剂量反应模型(P非线性<0.001,P线性=0.745)。
结论:J形剂量反应模式显示体重过轻,肥胖和病态肥胖增加了住院成人患者发生PIs的风险.较低和较高的BMI值可能意味着PI的风险增加,特别是在BMI较低的老年人中,为医务人员提供有价值的指导。
BACKGROUND: The association between underweight and pressure injuries (PIs) has been established in several studies. However, there is a lack of well-designed research investigating the connection between overweight and obesity with these injuries.
OBJECTIVE: This meta-analysis aims to investigate the dose-response relationship between body mass index (BMI) and the risk of PIs in adult hospitalized patients.
METHODS: PubMed, Web of Science, and MEDLINE Databases were searched from inception to May 2024. Observational articles with at least three BMI categories were included in the study. BMI was defined as underweight, normal weight, overweight, and morbid obesity for the meta-analysis. The non-linear relationship between BMI and the risk of PIs in hospitalized adults was investigated using restricted cubic spline models. Fractional polynomial modeling was used.
RESULTS: Eleven articles reporting at least 3 categories of BMI met the inclusion criteria, including 31,389 participants. Compared to patients with normal weight, those with underweight, obesity, and morbid obesity exhibited an increased risk of PIs, with odds ratios of 1.70 (95%CI:1.50-1.91), 1.12 (95%CI:1.02-1.24), 1.70 (95%CI:1.13-2.55), respectively. A J-shaped dose-response model was established for the relationship between PI risk and BMI (Pnon-linearity < 0.001, Plinearity = 0.745).
CONCLUSIONS: The J-shaped dose-response pattern revealed that underweight, obesity and morbid obesity heightened the risk of PIs in hospitalized adults. Lower and higher BMI values may signify an increased risk for PIs, particularly among the elderly with lower BMI, providing valuable guidance for medical staff.