Evidence map›Paper›PMID 42780485›Full record

ReviewInternational journal of nursing studies advances2026

Risk factors for position-related injuries in adult surgical patients: a systematic review and meta-analysis.

Veronica Ramirez Johansson, Oili Dahl, Ann-Charlotte Falk, Ulrica Nilsson, Marina Dehara, Ann-Christin von Vogelsang

Abstract readReview
In one paragraph

Review in International journal of nursing studies advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Veronica Ramirez JohanssonDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Oili DahlPerioperative Medicine and Intensive Care Function, Karolinska University Hospital, Stockholm, Sweden.
Ann-Charlotte FalkSwedish Society of Nursing, Stockholm, Sweden.
Ulrica NilssonDepartment of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden.
Marina DeharaDepartment of Medicine, Clinical Epidemiology Division, Karolinska Institutet, Stockholm, Sweden.
Ann-Christin von VogelsangDepartment of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Correct patient positioning is a vital responsibility of the operating team to ensure patient safety. By identifying risk factors associated with position-related injuries in surgical patients, perioperative nurses can develop effective strategies to prevent these iatrogenic injuries. Objective: To identify and synthesise intrinsic and extrinsic risk factors for position-related pressure injuries and peripheral nerve injuries. Information sources: Searches were conducted in Medline, Web of Science, CINAHL, Embase, and the Cochrane Library (January 1990 - September 2025). Methods: Observational studies examining intrinsic and extrinsic risk factors for new pressure injuries or peripheral nerve injuries in adult surgical patients were included. The risk of bias was assessed using the Research Triangle Institute item bank framework. Meta-analyses were performed using random-effects models, with sensitivity analyses regarding study design and risk of bias. Results: In total, 16 382 records were screened, and 161 full-text articles were assessed for eligibility. Of these, 41 studies were included (33 on pressure injuries comprising 26 074 patients and 8 on peripheral nerve injuries comprising 1 338 592 patients), assessing 101 potential risk factors. Four factors were found to be statistically significant in association with pressure injuries: diabetes (OR 1.89; 95% CI 1.25-2.86), high body mass index (MD 1.80; 95% CI 0.38 to 3.22), low preoperative serum albumin (MD -3.04; 95% CI - 4.99 to -1.09), and intraoperative use of circulatory agents (OR 2.11; 95% CI 1.13 to 3.92). Biological sex (OR 1.10; 95% CI 0.94-1.30), age (MD 0.69; 95% CI -1.65 to 3.03), hypertension (OR 1.37; 95% CI 0.93-2.01), low haemoglobin (MD -7.64; 95% CI -16.90 to 1.62), and surgery duration (MD 42.54; 95% CI -9.03 to 94.11) were not associated with injury risk. For peripheral nerve injuries, the available evidence on risk factors was too limited and heterogenous to permit meta-analysis. Conclusions: Surgical patients are at risk of position-related injuries, particularly in the presence of factors such as diabetes, high body mass index, low serum albumin, and use of circulatory agents. Preoperative optimisation and thorough postoperative assessment are essential to reduce these iatrogenic injuries. Registration: www.crd.york.ac.uk/prospero/ PROSPERO CRD42023401329, registered 21/02/2023.

Indexed as

Patient positioningPeripheral nerve injuriesPressure injuriesRisk factorsSurgery

Identifiers

PMID42780485
PMCPMC13598170

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.