Adhesive-related skin injuries in adult ICU patients: uncovering prevalence and key risk factors – a systematic review and meta-analysis
Bibliographic record
Abstract
Medical adhesive-related skin injury (MARSI) is a significant concern in ICU settings, contributing to patient discomfort, prolonged hospital stays, and increased healthcare costs. This systematic review aimed to evaluate the prevalence and identify risk factors associated with MARSI among ICU patients. A comprehensive search was conducted across major databases, including PubMed, Scopus, Web of Science, and Google Scholar, to identify observational studies assessing MARSI prevalence and risk factors in ICU patients. Studies in ICU settings with diverse subpopulations and risk factors were included. The Newcastle-Ottawa Scale (NOS) assessed study quality, and MetaXL 5.3 was used for statistical analyses, with pooled prevalence estimated via a random-effects model. Heterogeneity was assessed using Higgins I² and Cochran's Q tests. Seven studies, each with 100 to 430 ICU patients, met the inclusion criteria. MARSI prevalence ranged from 10.96% to 42%, with a pooled estimate of 21% (95% CI: 13% to 30%). Consistent risk factors included advanced age, skin fragility, prolonged ICU stay, mechanical ventilation, and chronic conditions such as diabetes and cardiovascular disease. Variations in prevalence appeared related to ICU type and diagnostic methods. MARSI is prevalent among ICU patients, underscoring the need for targeted preventive strategies for at-risk populations. Interventions like routine skin assessments, selective adhesive use, and alternative fixation methods could reduce MARSI risk. Standardized protocols and further research are recommended to improve comparability and patient outcomes in ICU settings.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.006 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".