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Background: The first step in preventing pressure injuries (PIs), which represent a significant burden on intensive care unit (ICU) patients and the health care system, is to assess the risk for developing PIs. A valid risk assessment scale is essential to evaluate the risk and avoid PIs. Objectives: To compare the predictive validity of the Braden scale and Waterlow scale in ICUs. Design: A multicentre, prospective and cross‐sectional study. Methods: We conducted this study among 6416 patients admitted to ICUs in Gansu province of China from April 2021 to October 2022. The incidence and characteristics of PIs were collected. The risk assessment of PIs was determined using the Braden and Waterlow scale. The sensitivity, specificity, positive and negative predictive values, and the area under the receiver operating characteristic curve of the two scales were compared. Results: Out of 5903 patients, 72 (1.2%) developed PIs. The sensitivity, specificity, positive and negative predictive, and the area under the curve of the Braden scale were 77.8%, 50.9%, 0.014 and 0.996, and 0.689, respectively. These values for the Waterlow scale were 54.2%, 71.1%, 0.017, 0.994 and 0.651. Conclusions: Both scales could be used for risk assessment of PIs in ICU patients. However, the accuracy of visual inspection for assessment of skin colour, nursing preventive measures for patients and scales inter‐rater inconsistency may limited the predictive validity statistics. Relevance to Clinical Practice: Both scales could be used for PIs risk assessment. The low specificity of the Braden scale and low sensitivity of the Waterlow scale remind medical staff to use them in combination with clinical judgement and other objective indicators. Patient or Public Contribution: This study was designed to enhance the management of PIs. Patients and the general public were not involved in the study design, analysis, and interpretation of the data or manuscript preparation. [ABSTRACT FROM AUTHOR]

To investigate the preventive effect of different dressings on pressure injuries related to non‐invasive ventilation equipment and to screen the efficacy of dressings. Systematic review and network meta‐analysis. PubMed, the Cochrane Library, Web of Science, EMBASE, Cumulative Index to Nursing & Allied Health Literature (CINAHL), China Knowledge Resource Integrated Database (CNKI), Wanfang Database, Chinese Biomedical Database (CBM) and Weipu Database (VIP) were used for the search from the date of inception of each database to 15 October 2023. The quality of the data was assessed using the Cochrane Risk of Bias tool. Stata 16.0 Software was used to analysis and ranking of different types of dressings. A total of 23 randomized controlled trials on 7 interventions were included in the final analysis. The effectiveness of these in preventing the overall incidence of pressure injuries is ranked from best to worst as follows: hydrogel dressing > foam dressing > petroleum jelly gauze dressing > hydrocolloid dressing > film dressing > clean gauze dressing > sterile gauze. Sixteen studies reported the incidence of Stage I pressure injuries, the effectiveness in preventing the incidence of Stage I pressure injuries was ranked from best to least effective: foam dressing > hydrogel dressing > petroleum jelly gauze dressing > hydrocolloid dressing > film dressing > clean gauze dressing > sterile gauze dressing. Fourteen studies reported the incidence of Stages I/II pressure injuries, the effective in preventing the incidence of Stages I and II pressure injuries was ranked from best to least effective: foam dressing > hydrogel dressing > petroleum jelly gauze dressing > hydrocolloid dressing > clean gauze dressing > sterile gauze dressing. Considering the advantages and disadvantages of different dressings, both hydrogel and foam dressings are effective in preventing pressure injuries related to non‐invasive ventilation equipment. [ABSTRACT FROM AUTHOR]

Deep tissue injuries (DTIs) are a serious type of pressure injuries that mainly occur at the bony prominences and can develop rapidly, making prevention and treatment more difficult. Although consistent research efforts have been made over the years, the cellular and molecular mechanisms contributing to the development of DTIs remain unclear. More recently, ferroptosis, a novel regulatory cell death (RCD) type, has been identified that is morphological, biochemical and genetic criteria distinct from apoptosis, autophagy and other known cell death pathways. Ferroptosis is characterized by iron overload, iron‐dependent lipid peroxidation and shrunken mitochondria. We also note that some of the pathological features of DTI are known to be key features of the ferroptosis pathway. Numerous studies have confirmed that ferroptosis may be involved in chronic wounds, including DTIs. Here, we elaborate on the basic pathological features of ferroptosis. We also present the evidence that ferroptosis is involved in the pathology of DTIs and highlight a future perspective on this emerging field, desiring to provide more possibilities for the prevention and treatment of DTIs. [ABSTRACT FROM AUTHOR]

To compare the predictive properties of the Jackson/Cubbin scale and Waterlow scales in intensive care unit patients. A multi‐centre study. This study was conducted between April 2021 and February 2023 in 72 intensive care units of 38 tertiary hospitals in Gansu Province, China. All adults admitted to the intensive care unit for 24 hours or more without pressure injury on admission were screened using the Waterlow scale and Jackson/Cubbin scales in intensive care. Additionally, the negative predictive value, positive predictive value, sensitivity, specificity and receiver operating characteristic curve with area under the curve of the Waterlow scale and Cubbin/Jackson scales were determined. The participant population for this study included 6203 patients. Predictive properties for the Jackson/Cubbin scales and Waterlow scales, respectively, were as follows: Cut‐off scores, 28 versus 22; AUC, 0.859 versus 0.64; sensitivity, 92.4% versus 51.9%; specificity, 67.26% versus 71.46%; positive predictive value, 35% versus 23%; negative predictive value, 99.9% versus 99.1%. Both Waterlow scales and Jackson/Cubbin scales could predict pressure injury risk for patients in the intensive care unit. However, the Jackson/Cubbin scale demonstrated superior predictive properties than the Waterlow scale. [ABSTRACT FROM AUTHOR]

Despite the fact that machine learning (ML) algorithms to construct predictive models for pressure injury development are widely reported, the performance of the model remains unknown. The goal of the review was to systematically appraise the performance of ML models in predicting pressure injury. PubMed, Embase, Cochrane Library, Web of Science, CINAHL, Grey literature and other databases were systematically searched. Original journal papers were included which met the inclusion criteria. The methodological quality was assessed independently by two reviewers using the Prediction Model Risk of Bias Assessment Tool (PROBAST). Meta‐analysis was performed with Metadisc software, with the area under the receiver operating characteristic curve, sensitivity and specificity as effect measures. Chi‐squared and I2 tests were used to assess the heterogeneity. A total of 18 studies were included for the narrative review, and 14 of them were eligible for meta‐analysis. The models achieved excellent pooled AUC of 0.94, sensitivity of 0.79 (95% CI [0.78–0.80]) and specificity of 0.87 (95% CI [0.88–0.87]). Meta‐regressions did not provide evidence that model performance varied by data or model types. The present findings indicate that ML models show an outstanding performance in predicting pressure injury. However, good‐quality studies should be conducted to verify our results and confirm the clinical value of ML in pressure injury development. [ABSTRACT FROM AUTHOR]

Total knee arthroplasty (TKA) is considered a common surgical option in patients with end-stage osteoarthritis of the knee. This systematic review and meta-analysis aimed to determine the effectiveness of cognitive behavioral therapy (CBT) for patients after TKA. PubMed, EMBASE, the Cochrane Library, Web of Science and CINAHL were searched for randomized controlled trials (RCTs) from inception to 20 August 2021. Included studies were evaluated with the Cochrane risk-of-bias tool. Six RCTs were included. Our study results demonstrated that a significant reduction in pain catastrophing was seen in patients receiving CBT at post-intervention (SMD −0.48, 95% CI = −0.72 to −0.23, I2 17.2%, p = 0.00) but not in 3-month or 12-month follow-up. There were no significant differences between CBT and usual-care patients regarding pain intensity or knee function at different time-points. This is the first time that meta-analysis has been conducted to determine the effectiveness of CBT for patients after TKA. It is necessary to conduct longer follow-ups, include larger samples and conduct rigorous RCTs to further explore this issue. [ABSTRACT FROM AUTHOR]

Aims: The aim of this study was to investigate the incidence of alexithymia in intensive care unit nurses and determine the associated factors. Design: A multi‐center, cross‐sectional study. Methods: In total, 485 nurses in intensive care unit were recruited from 53 hospitals in China. Data collection tools used in the study included demographic characteristics, the Social Support Rating Scale (SSRS), Emotional Intelligence Scale (EIS), and the 20‐item Toronto Alexithymia Scale (TAS‐20). SPSS 25.0 software (Corp., Armonk, NY, USA) was used to preform data analysis. Results: About 43.7% of intensive care unit nurses were classified as alexithymia in the whole sample (males: 50%, females: 43%). The median TAS‐20 score was 60 (interquartile range = 9). The study found that alexithymia was significantly associated with marital status, whether living alone, working years, and social support (Adjusted R Squared = 0.194, F = 6.466, p < 0.01), while emotional intelligence was not statistically significant with alexithymia. Conclusions: Alexithymia is a psychological problem with high incidence in intensive care unit nurses. In this study, being unmarried or divorced, living alone, and having fewer years of work (≤5 years) were associated with a higher risk of alexithymia. Interventions that strengthen social support may also help improve the mental health of ICU nurses. [ABSTRACT FROM AUTHOR]

To systematically assess the prevalence of facial pressure injuries related to adult non‐invasive ventilation equipment, and risk factors of facial pressure injuries. PubMed, Cochrane Library, Web of Science, Embase, China Knowledge Resource Integrated Database, Wanfang Database, Chinese Biomedical Database and Weipu Database were comprehensively searched for observational studies investigating the prevalence and risk factors of facial pressure injuries related to adult non‐invasive ventilation equipment from inception to May 16th, 2022. Filter articles based on inclusion and exclusion criteria. The quality of the included studies was evaluated independently by two investigators. Meta‐analysis was conducted using Stata 16.0 software package. In total, 2835 articles were screened and data from 12 studies were used in meta‐analysis. The prevalence of facial pressure injuries related to adult non‐invasive ventilation equipment was 25% (95% confidence interval, CI:15% to 37%, I2 = 97.34%, P < 0.0001). After controlling for confounding variables, the following risk factors of facial pressure injuries: use equipment form, with diabetes, fever, cumulative time of using equipment, facial skin oedema and Glasgow score. Understanding the risk factors of facial pressure injuries can provide the healthcare personnel with the theoretical basis for the management and treatment of the patients. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This study aimed to understand the risk factors that contribute to medical device‐related (MDR) nasal mucosal membrane pressure injuries (MM PI) in ICU patients. Background: ICU patients require substantial tube‐based life support such as oxygen tubes, tracheal intubation and indwelling gastric tubes. As a result, there is an increased risk of PI occurrence; however, few studies have assessed the risk factors associated with nasal mucosal MDR‐MMPI in ICU patients. Design: A cross‐sectional study design was performed. Methods: From January 2019 to June 2020, data from 912 patients treated in the ICU of a tertiary first‐class a hospital in China were collected. The occurrence of PI of the nasal mucosa was obtained by nasopharyngoscope when replacing the nasal catheter fixation patch every day. The study methods were followed by the STROBE guidelines. Results: The incidence of nasal mucosal MDR‐MM PI was 10.9%. The degree of nasal mucosal MM PI was mainly grade 1 (62cases, 62.6%), and no grade 4 were observed. The columella (58 cases, 58.6%) was the most common site of nasal mucosal MM PI followed by the anterior septum (18 cases, 18.2%). A high patient APACHE‐Ⅱ score, the disturbance of consciousness, a history of diabetes, days of gastric tube indwelling, hypoproteinemia, fever (T > 37.5℃) and the use of vasoconstrictors were identified as significant influencing factors of nasal MM PI in ICU patients (p <.05). Conclusions: A high APACHE‐Ⅱ score, disturbance of consciousness, history of diabetes, days of gastric tube indwelling, hypoproteinemia, fever (T > 37.5℃) and use of vasoconstrictive drugs were risk factors for nasal mucosal MDR‐MM PI in ICU patients. This study informs on the risk factors of nasal mucosal MM PI that will allow medical support staff to carry out key interventional measures to prevent nasal mucosal MM PI. Relevance to clinical practice: This study illustrates the characteristics and risk factors of nasal mucosal pressure injury in intensive care units, potentially contributing to the prevention of the incidence of nasal mucosal MDR‐PI in ICU patients. [ABSTRACT FROM AUTHOR]