A Systematic Review of Risk Prediction Models for Skin Damage around Enterostomy Sites

Objective: To conduct a systematic review of risk prediction models for peristomal skin damage in patients with enterostomy, analyze the construction methods, clinical predictive performance, and predictors of relevant models, and provide a reference for clinical decision-making.Methods: A systematic search was performed in PubMed, Web of Science, Embase, Chinese Biomedical Literature Database, CNKI, Wanfang, and VIP databases from inception to March 2026 to comprehensively retrieve studies on risk prediction models for peristomal skin damage in enterostomy patients.The risk of bias of included studies was assessed using the Prediction model Risk of Bias Assessment Tool (PROBAST), evaluating four domains: participants, predictors, outcomes, and analysis.Results: A total of 12 studies were included.The modeling methods comprised Logistic regression and decision tree.The sample size ranged from 120 to 617, and the area under the curve ranged from 0.803 to 0.914.The most frequently identified predictor was stoma site, followed by stoma height, history of radiotherapy/chemotherapy, and flange fit.Conclusions: The included models demonstrate good predictive performance but overall high risk of bias.Model performance may be overestimated, and clinical applicability requires further validation.Future studies should follow the PROBAST and TRI-POD guidelines, avoid univariate screening for variable selection, ensure adequate sample size, and perform external validation.