Munro量表对手术患者压力性损伤预测效果的Meta分析

Predictive validity of the Munro Scale for pressure injuries in surgical patients: A meta-analysis

目的采用Meta分析评价Munro量表在手术患者中压力性损伤的预测效果。方法计算机检索Pubmed、Embase、the Cochrane Library、Google Scholar、中国生物医学文献数据库(CBM)、中国知网(CNKI)、维普数据库(VIP)和万方数据库(Wanfang Data)关于评价Munro量表在手术患者中压力性损伤预测效果的研究。采用诊断性研究质量评价工具(QUADAS-2)评价所纳入文献的质量,采用Meta-Disc 1.4分析数据。结果共纳入4篇文献,720例患者。Munro量表术前、术中、术后3个阶段的合并灵敏度分别为0.64 (95%CI:0.52~0.75)、0.85 (95%CI:0.75~0.92)、0.77(95%CI:0.66~0.86),术前、术中、术后3个阶段的合并特异度分别为0.66 (95%CI:0.62~0.69)、0.69(95%CI:0.66~0.73)、0.82(95%CI:0.79~0.85),术前、术中、术后3个阶段的SROC曲线下面积分别为0.75、0.60、0.88。结论 Munro量表的部分内容存在差异,尚未统一,对手术患者压力性损伤的预测有效性是中等水平,仍需进一步的研究。

Objective To present the predictive validity of the Munro scale for pressure injuries in surgical patients through a meta-analysis. Methods The bibliography was reviewed through the Pubmed, Embase, the Cochrane Library, Google Scholar, CBM, CNKI, Wanfang Data, VIP. The Quality Assessment on Diagnostic Accuracy Studies(QUADAS-2) tool was applied for assessment the internal validity of the diagnostic studies. Meta Disc 1.4 was used to analyze the selected studies. Results Four diagnostic articles with high methodological quality, involving 720 surgical patients, were identified. The meta-analysis revealed that preoperative pooled sensitivity, intraoperative pooled sensitivity and postoperative pooled sensitivity were 0.64(95%CI:0.52-0.75), 0.85(95%CI:0.75-0.92), 0.77(95% CI:0.66-0.86);preoperative pooled specificity, intraoperative pooled specificity and postoperative pooled specificity were 0.66(95%CI:0.62-0.69), 0.69(95%CI:0.66-0.73), 0.82(95%CI:0.79-0.85);preoperative SROC, intraoperative SROC, postoperative SROC was 0.75, 0.60, 0.88. Conclusion The results suggest that Munro scale is differential and has moderate predictive validity and the possibility for pressure injuries, that the predictive validity of the Munro scale need more studies to be confirmed.