Abstract / Summary
To systematically evaluate existing prediction models for medical adhesive-related skin injury and assess their potential contribution to nurse-led risk assessment and preventive care planning.
A systematic review and meta-analysis was conducted. Seven databases were searched from inception to 25 October 2025. Studies developing prediction models for medical adhesive-related skin injury in adults were assessed using the Prediction Model Risk of Bias Assessment Tool. Random-effects meta-analyses were used to synthesize prevalence estimates, model discrimination and common predictors.
Twelve studies comprising 14 prediction models were included. Reported area under the curve or C-index values ranged from 0.789 to 0.960. In the nine studies included in the discrimination meta-analysis, the pooled area under the curve was 0.87 (95% confidence interval: 0.84-0.90). All studies had a high overall risk of bias, and none performed external validation. The pooled prevalence of medical adhesive-related skin injury was 22.0% (95% confidence interval: 18.5%-25.4%). Age over 60 years, a history of medical adhesive-related skin injury, allergy history, edema, study-defined hypoproteinemia, and moist skin were associated with higher odds, whereas higher Braden Scale scores were associated with lower odds.
Existing models are not ready for stand-alone clinical use because of their high risk of bias and lack of external validation. Further well-designed studies are needed to develop and externally validate clinically useful prediction models for medical adhesive-related skin injury.
The identified factors may help nurses prioritise closer skin assessment, surveillance, and individualised preventive care. They should be considered within a comprehensive nursing assessment rather than used as a validated risk score or intervention threshold.
None because this review used previously published evidence.
PROSPERO registration number CRD420251179067.