Objectives: Intensive care unit (ICU) patients are at high risk of medical device related pressure injury (MDRPI). This study aims to ascertain the MDRPI prevalence in ICU patients and analyse the risk factors of MDRPI. Background:The occurrence of MDRPI not only increases hospitalisation time with pain and economic burden, but also causes medical disputes. A better understanding of this condition will increase knowledge and facilitate the ability to recognise and prevent MDRPI for clinical nursing staff. However, there are few multicentre studies of MDRPI prevalence in ICU patients in China. Design:A cross-sectional study design was employed.Methods: Data from 694 patients in 66 adult ICU at 30 hospitals in China were included between October 2018 and March 2019. The stage of each MDRPI was determined according to the definitions of National Pressure Ulcer Advisory Panel. The study methods were followed by the STORBE guidelines. Results:The overall prevalence rate of MDRPI was 13.1% (91/694), with 98 anatomic locations in total. The most common stages of MDRPI were stage 1 (54.1%, 53/98), stage 2 (15.3%, 15/98) and mucosal membrane pressure injury (15.3%, 15/98). MDRPI mainly occurred in the finger (32.7%, 32/98), followed by nose (18.4%, 18/98). The prevalence rate of MDRPI caused by CPAP or BiPAP masks (25%) was highest. Lower Braden scores and having skin oedema were risk factors for MDRPI in adult ICU patients. Conclusion:The prevalence of MDRPI in this study was still high. Nurses should take these related factors into consideration when taking care of ICU patients, and appropriate prevention measures should be adopted to decrease the prevalence of MDRPI.Relevance to clinical practice: The study can help to improve the PI prevention efforts in ICU patients specific to medical device related PI.

Purpose To explore the incidence, severity, and risk factors of multidimensional fatigue in patients with nasopharyngeal carcinoma (NPC) receiving concurrent chemoradiotherapy (CCRT). Methods This prospective study included 79 patients with NPC in Guangzhou (China) from June 2015 to July 2018. Data were collected before and after CCRT, including demographic and clinical characteristics, nutritional parameters, and fatigue scores, based on completion of the Multiple Dimensional Inventory-20 Questionnaire, with five subscales: General Fatigue, Mental Fatigue, Physical Fatigue, Reduced Activity, and Reduced Motivation. Results Increased general fatigue was found to be associated with lower lymphocyte count and body mass index <23 kg/m 2 . Increased physical fatigue was related to age > 42 years. Higher scores for reduced activity were associated with age > 42 years, female sex, and lower serum sodium. Increased mental fatigue was related with lower lymphocyte count and unemployment; and increased total fatigue was associated with lower lymphocyte count, age > 42 years, and 3-6 courses of treatment. Furthermore, 3-6 courses of treatment was an independent predictor of severe general fatigue, while age >42 years was an independent predictor of severe physical fatigue. Importantly, cancer stage IVB and 3-6 courses of treatment could predict severe total fatigue. Conclusions Our data demonstrate that fatigue is increased in all dimensions in NPC patients following CCRT, and that the predictors differ for each fatigue dimension. These results could guide the development of targeted interventions that may reduce the impact of cancer-related fatigue in patients with NPC.

Objective Postoperative cerebrospinal fluid (CSF) leakage represents a challenge even for experienced pituitary surgeons. We aimed to quantitatively synthesize data from studies regarding the risk factors for postoperative CSF leakage after transsphenoidal surgery (TSS) for pituitary adenoma (PA). Methods PubMed, Web of Science, The Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), Wanfang database, and VIP database were searched for case–control and cohort studies, focusing on the risk factors associated with postoperative CSF leakage after TSS for PA. Pooled odds ratios (ORs) and 95% confidence intervals were calculated to determine the risk factors. Results A total of 34 case–control and cohort studies involving a total of 9,144 patients with PA were included in this systematic review. The overall rate of postoperative CSF leakage after TSS for PA was 5.6%. Tumor size, adenoma consistency, revision surgery, and intraoperative CSF leakage were independent risk factors for postoperative CSF leakage (ORs, 3.18–6.33). By contrast, the endoscopic approach showed a slight protective benefit compared with the microscopic approach in TSS (OR, 0.69). Conclusions This review provides a comprehensive overview of the quality of the evidence base, informing clinical staff of the importance of screening risk factors for postoperative CSF leakage after TSS for PA. More attention should be paid to PA patients at high risk for CSF leakage after TSS to reduce complications and improve prognosis.

No abstract

Objective: Postoperative cerebrospinal fluid (CSF) leakage represents a challenge even for experienced pituitary surgeons. We aimed to quantitatively synthesize data from studies regarding the risk factors for postoperative CSF leakage after transsphenoidal surgery (TSS) for pituitary adenoma (PA).Methods: PubMed, Web of Science, The Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), Wanfang database, and VIP database were searched for case–control and cohort studies, focusing on the risk factors associated with postoperative CSF leakage after TSS for PA. Pooled odds ratios (ORs) and 95% confidence intervals were calculated to determine the risk factors.Results: A total of 34 case–control and cohort studies involving a total of 9,144 patients with PA were included in this systematic review. The overall rate of postoperative CSF leakage after TSS for PA was 5.6%. Tumor size, adenoma consistency, revision surgery, and intraoperative CSF leakage were independent risk factors for postoperative CSF leakage (ORs, 3.18–6.33). By contrast, the endoscopic approach showed a slight protective benefit compared with the microscopic approach in TSS (OR, 0.69).Conclusions: This review provides a comprehensive overview of the quality of the evidence base, informing clinical staff of the importance of screening risk factors for postoperative CSF leakage after TSS for PA. More attention should be paid to PA patients at high risk for CSF leakage after TSS to reduce complications and improve prognosis.