Risk Factors for Facial Pressure Injuries in Adults Receiving Non-Invasive Positive Pressure Ventilation: A systematic review and meta-analysis

Objectives This systematic review and meta-analysis aimed to identify risk factors for facial pressure injuries. Methods The study adhered to the PRISMA reporting guidelines and conducted a comprehensive search across nine databases: PubMed, Web of Science, Cochrane Library, OVID, Embase, Chinese Biomedical Database, China Knowledge Resource Integrated Database, Wanfang Database, and Weipu Database, to identify the risk factors for facial pressure injuries. Observational studies investigating these risk factors were included, with data collection up to April 15, 2026, for database construction. The quality of the literature was assessed using the 2016 edition of the Australian Joanna Briggs Institute Centre for Evidence-Based Health Care Evaluation Criteria and the Newcastle-Ottawa Scale. Results 19 studies involving 4,119 samples were included. The findings indicated that the overall prevalence of facial pressure injuries was 32%. Ten factors associated with the development of facial pressure injuries included non-invasive ventilation protocol, fever, cumulative duration of non-invasive ventilation, the use of vasoactive drugs, PCO 2 ≥ 50 mmHg, diabetes, acute physiology and chronic health evaluation II score, Glasgow coma scale, albumin levels, and age. Conclusions Comprehending the risk factors linked to facial pressure injuries can facilitate the early identification of high-risk individuals and mitigate the occurrence of such injuries.