Personal risk factors for pressure injuries among wheelchair users: an umbrella review of new insights in 2024
Bibliographic record
Abstract
PURPOSE: Pressure injuries (PrI) are a prevalent and serious health issue for wheelchair users. This study aims to identify the personal factors associated with PrI occurrence and their significance by synthesizing existing literature. MATERIALS AND METHODS: We conducted an umbrella review, systematically searching four databases for reviews published from 2007 to May 2024. The search terms were selected by an independent, experienced librarian. To evaluate the risk of bias and methodological quality of the included studies, we applied the ROBIS tool and the GROOVE procedure. Identified risk factors were categorized into relevant groups. RESULTS: After an assessment of 5,797 potential articles, 21 studies met the inclusion criteria. Among these, 43% were systematic reviews, 24% meta-analyses, 19% literature reviews, 9% scoping reviews, and 5% narrative reviews. The findings revealed 33 individual personal factors, categorized into the general health, clinical condition, initial pathology, environment/lifestyle, person-related, and combined risk factor groups. Key individual risk factors frequently encountered among wheelchair users included advanced age, obesity, spinal cord injury (SCI), higher levels of SCI, diabetes, infections, incontinence, immobility, respiratory and perfusion impairments, sensory perception issues, and low physical activity. CONCLUSIONS: This study is the first to synthesize literature on internal risk factors associated with PrI among wheelchair users. It confirmed well-established factors such as SCI, diabetes, and aging. The findings provide healthcare professionals and decision-makers with critical information for the prevention and management of PrI in this population, offering new insights into adopting a holistic approach to assessing and addressing individual risks factors.
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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 | 0.002 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 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".