Journal of Clinical Nursing

Incidence Rate and Risk Factors for Oral Endotracheal Tube‐Related Mucous Membrane Pressure Injury in Critically Ill Patients: A Systematic Review and Meta‐Analysis

ABSTRACT

Objectives

To summarise the incidence rate and identify the risk factors for oral endotracheal tube-related mucous membrane pressure injury (OETMMPI) in critically ill patients.

Methods

This systematic review and meta-analysis followed the PRISMA 2020 requirements. We searched the databases PubMed, Embase, Web of Science, the Cochrane Library, WanFang, China Science and Technology Journal Database (VIP), China National Knowledge Infrastructure (CNKI) and China Biomedical Literature Database (SinoMed) from conception to July 3, 2025. Two independent researchers read the publications, assessed them and extracted data. Stata 18.0 software was used to conduct the analyses.

Result

This meta-analysis comprised 16 observational studies. Two studies recorded the number of days of tracheal intubation rather than the number of patients who required it, which totaled 274 days. The remaining 14 trials included a total of 6768 adult patients. The incidence rate of OETMMPI was 28.9% (95% CI = 0.177–0.417). Risk factors include tracheal catheter indwelling time (OR = 1.13), APACHE II score (OR = 1.39), use of hard bite blocks (OR = 1.88), prone ventilation (OR = 3.95), diabetes history (OR = 4.86), vasoconstrictor medication use (OR = 2.11) and albumin level (OR = 0.50).

Conclusions

The incidence rate of OETMMPI is relatively high in critically ill patients, and there are many influencing factors. Nursing staff should enhance their awareness of OETMMPI, accurately identify high-risk groups and risk factors, and formulate early, full-course, meticulous and personalised intervention measures for critically ill patients to prevent OETMMPI.

Implications for Clinical Practice

OETMMPI in critically ill patients brings pain to the patients, increases the risk of infection and affects the prognosis of the disease. Therefore, medical staff should regularly assess and address it. This study also identified specific related factors, and these results provided valuable insights for the ICU medical team to identify high-risk patients and offer personalised intervention measures to reduce their occurrence.