The Frequency of Osteomyelitis After Pressure Injury in Spinal Cord Injury: A Systematic Review and Meta-Analysis Publisher Pubmed



Jangholi E^{1, 2, 3} ; Alizadeh SD¹ ; Farahbakhsh F^{1, 3, 4} ; Baigi V^{1, 5} ; Ghodsi Z^{1, 2} ; Mahdavi Sharif P¹ ; Ghashghaei S^{1, 6} ; Abbaszadeh M^{1, 6} ; Zeinaddini Meymand A¹ ; Eskandari Z⁷ ; Rahimimovaghar V^{1, 8}
Source: Spinal Cord Series and Cases Published:2024

Abstract

Study design: A systematic review and meta-analysis Objective: To determine the global frequency of osteomyelitis in individuals with spinal cord injury who have pressure injuries (SCI-PI). Methods: A comprehensive search on PubMed, EMBASE, Scopus, and the Web of Science has been conducted until November 2023. The Cochrane Handbook for Systematic Reviews was followed. Cohort and cross-sectional studies included SCI-PI participants who reported the frequency of osteomyelitis without language restriction. Data extraction was performed by four reviewers in two groups. We used the Newcastle-Ottawa Quality Assessment Scale for quality assessment. The Chi-squared and I2 tests were applied to detect heterogeneity between studies. Also, a random-effects model was performed for the report data. Results: Ten out of 986 studies met our eligibility criteria, with 492 SCI-PI individuals. It was discovered that most SCIs were thoracolumbar injuries and male. There was a history of PI in more than half the patients. SCI was primarily caused by trauma. A meta-analysis revealed a significantly heterogeneous 43.0% osteomyelitis frequency. There was no evidence of publication bias. Subgroup analysis based on study quality revealed that the frequency of osteomyelitis in low-quality studies was 34.5%, whereas the frequency in high-quality research was 47.4%. Furthermore, the overall frequency of osteomyelitis was 29.0% in the subgroup analysis of research carried out in the USA. Conclusions: Our study highlights the significant burden of osteomyelitis among SCI-PI individuals. These findings underscore the pressing need for standardized diagnostic and management protocols to mitigate the morbidity associated with osteomyelitis in this vulnerable population. © The Author(s), under exclusive licence to International Spinal Cord Society 2024.