Predictive validity of the Spinal Cord Injury Pressure Ulcer Scale (SCIPUS) in acute care and inpatient rehabilitation in individuals with traumatic spinal cord injury

Article type: Research Article

Authors: Krishnan, Shilpa^{a; *} | Brick, Rachelle S.^b | Karg, Patricia E.^b | Tzen, Yi-Ting^c | Garber, Susan L.^d | Sowa, Gwendolyn A.^e | Brienza, David M.^{b; f}

Affiliations: [a] Division of Rehabilitation Sciences, University of Texas Medical Branch, Galveston, TX, USA | [b] Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA, USA | [c] Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, USA | [d] Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Baylor, CA, USA | [e] Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA, USA | [f] Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA

Correspondence: [*] Address for correspondence: Shilpa Krishnan, Division of Rehabilitation Sciences, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX 77555-1137, USA. E-mail: [email protected].

Abstract: OBJECTIVE: To evaluate the validity of the Spinal Cord Injury Pressure Ulcer Scale (SCIPUS) during acute care and inpatient rehabilitation following spinal cord injury (SCI) by determining critical cutoff points and assessing the ability to predict risk for pressure ulceration (PrU). DESIGN: Retrospective. METHODS: Sensitivity, specificity, and area under the curve (AUC) for the receiver operating characteristic were determined for the scale’s ability to predict PrU 2-3 and 5-7 days after administrating the SCIPUS during acute care, and 5-7 and 14-21 days after administrating the SCIPUS during inpatient rehabilitation. RESULTS: During acute hospitalization, SCIPUS’s ability to assess risk for PrUs within 2-3 days was determined at cutoff score of 15 with 100% sensitivity and 75% specificity, AUC = 0.85. The scale was unable to assess PrU risk at 5-7 days, AUC < 0.6 at cutoff score of 13. During inpatient rehabilitation, the scale was unable to assess PrU risk at 5-7 and 14-21 days, AUC < 0.6 at cutoff score of 9. CONCLUSIONS: The SCIPUS could predict PrU occurring within 2-3 days following administration during acute, but unable to predict over a longer term within acute or inpatient rehabilitation. Improved PrU risk assessment following SCI may be possible with modification to the SCIPUS.

Keywords: Spinal cord injury, pressure ulcer, risk assessment, validity, sensitivity, specificity

DOI: 10.3233/NRE-161331

Journal: NeuroRehabilitation, vol. 38, no. 4, pp. 401-409, 2016