Incidence and risk factors of oral mucosal pressure injury in patients with oral tracheal intubation: systematic review and meta-analysis

Background: To systematically review the incidence and risk factors of oral mucosal pressure injury in patients with oral tracheal intubation. Methods: Two researchers independently searched eight databases, PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), WanFang Database, VIP Database and China BioMedical Literature Database (CBM) from inception to February 27th, 2026. Data analyses were performed using Stata 18.0 software. Result: Twenty-four studies (9,904 patients) were included in the meta-analysis. The incidence of oral mucosal pressure injury in patients undergoing oral tracheal intubation was 29%. Risk factors include higher APACHE II score[OR 1.32, 95%CI:1.19-1.50], diabetes [OR 5.31, 95%CI: 1.88-14.87], serum albumin [OR0.37,95%CI:0.2-0.68], use of anticoagulants [OR 1.68, 95%CI: 1.02-2.77], use of sedative drugs [OR 3.35, 95%CI: 2.16-5.21], use of vasoactive drugs [OR 1.55, 95%CI: 1.25-1.92], prone position ventilation [OR 3.94, 95%CI: 2.64-5.93], prolonged tracheal intubation indwelling time [OR 1.08, 95%CI: 1.05-1.12], use of hard dental pads [OR 3.22, 95%CI: 2.25-4.66], tracheal intubation model [OR 2.72, 95%CI: 1.62-4.62]. Conclusion: The incidence of oral mucosal pressure injury is relatively high in patients with oral tracheal intubation, and there are many risk factors. Nursing staff should enhance their awareness of oral mucosal pressure injury in patients with oral tracheal intubation. They should accurately identify high-risk groups at an early stage based on risk factors and formulate targeted and personalized preventive measures to reduce the risk of injury. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251062658, identifier PROSPERO (CRD420251062658).