The prevalence and risk factors of medical adhesive-related skin injury in cancer patients with peripherally inserted central catheter: A systematic review and meta-analysis

Abstract

Background:

Medical adhesive-related skin injury (MARSI) is a significant but underreported complication, particularly in cancer patients with peripherally inserted central catheters (PICC). This systematic review and meta-analysis aimed to estimate the prevalence of MARSI and identify key risk factors in this patient population.

Methods:

A systematic search of PubMed, Embase, the Cochrane Library, CNKI, Wanfang, and VIP was conducted to identify studies reporting MARSI prevalence and risk factors in cancer patients with PICC. Pooled prevalence estimates and odds ratios (ORs) for risk factors were calculated using a random-effects model. Heterogeneity was assessed using the I² statistic, and subgroup analyses were performed to explore potential sources of heterogeneity. Publication bias was assessed using funnel plots and Egger’s test.

Results:

A total of 20 studies met the inclusion criteria, encompassing 8411 patients. The pooled prevalence of MARSI was 22% (95% CI: 18–26), with substantial heterogeneity across studies (I² = 96.3%). Subgroup analysis revealed that retrospective studies reported higher prevalence (25%) compared to prospective studies (16%). Key risk factors included advanced age (OR: 2.593, 95% CI: 1.322–5.089), higher BMI (OR: 2.927, 95% CI: 2.029–4.223), pre-existing skin conditions (OR: 2.487, 95% CI: 1.693–3.650), and the use of transparent film dressings (OR: 3.228, 95% CI: 2.086–5.001). Funnel plot and Egger’s test showed no significant publication bias.

Conclusions:

MARSI is prevalent in cancer patients with PICC. Modifiable risk factors should guide prevention strategies, including careful adhesive selection and regular skin assessments to improve patient outcomes.