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Absolute Versus Relative Skin Temperature as Early Warning Indicator for Pressure Injury: A Systematic Review and
Ke Xu1,2, Hua Cao1, Lingxiao Ran3
1Department of Neurosurgery, West China Hospital, West China School of Nursing, Sichuan University, Chengdu, China.
Aims:
Skin temperature, including absolute temperature (at bony prominence areas under long-term compression) and relative temperature (the difference between bony prominence and adjacent control area), may serve as early warning indicators for PI. However, the optimal indicator remains unclear. This meta-analysis therefore synthesises evidence on their association with PI risk to identify the best indicator and evaluate its early-warning accuracy.
Design:
Systematic review and meta-analysis.
Methods:
We included prospective cohort studies of adult patients investigating longitudinal associations between skin temperature and subsequent PI development. We pooled standardised mean difference (SMD) and odds ratios, complemented by summary receiver operating characteristic (SROC) curve analysis. The overall quality of evidence was evaluated using the GRADE method.
Data Sources:
We researched PubMed, Embase, CINAHL, Cochrane Library (CENTRAL), Wanfang and CNKI databases from inception to September 25, 2024.
Results:
After screening 1354 titles and abstracts, ten studies comprising 1742 participants were included in the final synthesis. No significant difference in absolute temperature (combined SMD) was found between the PI and non-PI groups (seven studies included). In addition, decreased relative temperature (< -0.1°C) was associated with a 16-fold increased likelihood of PI (95% CI 6.38-40.19, I2 = 79.4%) (three studies included), with the SROC curve analysis showing an AUC of 0.776. According to GRADE, the evidentiary certainty was very low for AT and low for RT.
Conclusions:
Relative temperature is significantly related to the risk of PI, supporting its role as a promising early warning indicator. Future studies should establish a standardised measurement protocol to facilitate its clinical application.
Implications For The Profession:
Monitoring skin temperature changes holds promise as a non-invasive tool for early warning of PI risk. However, the amount and quality of available evidence limit our confidence in these findings, underscoring the need for further research before a definitive conclusion can be drawn.
Reporting Method:
This study followed PRISMA guidelines.
Patient Or Public Contribution:
No patient or public contribution.
Trial Registration:
PROSPERO CRD42024550099.
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