Article

OBJECTIVE: To assess the psychometric properties of the Spinal Cord Injury
Pressure Ulcer Scale (SCIPUS) for pressure ulcer (PU) risk assessment during
inpatient rehabilitation.
DESIGN: Prospective cohort.
SETTING: Tertiary
rehabilitation centers. PARTICIPANTS: Individuals
(N=759) participating in
inpatient spinal cord injury rehabilitation between January 3, 2012, and April
23, 2014. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Admission SCIPUS
scores and the corresponding risk stratification, PU incidence, intraclass
correlation coefficient (ICC) for interrater reliability, sensitivity,
specificity, and likelihood ratios (LRs). Receiver operating characteristic
analysis was performed to calculate the area under the curve (AUC). RESULTS: Mean
SCIPUS scores were higher for individuals who developed PUs than for those who
did not (mean SCIPUS score, 9.8+/-2.5 vs 8.5+/-2.6). Interrater reliability was
excellent for SCIPUS composite scores (ICC=.91) and very good for risk
stratification (ICC=.86). Using the existing cutoff value of >/=6 for "high risk"
category, sensitivity and specificity were estimated to be .97 and .12,
respectively, with an LR of 1.1.
A cutoff value of >/=8 yielded a better balance
between sensitivity and specificity (.85 and .38, respectively). The AUC equaled
.64 with an LR of 1.4. Results were similar when the analysis was confined to PUs
of stage II or greater. CONCLUSIONS: The psychometric properties of the SCIPUS do
not currently support its routine use as a measure of PU risk in individuals with
spinal cord injury undergoing inpatient rehabilitation. LRs of <2 indicate that
stratification as high risk or very high risk does not substantially increase the
likelihood of identifying individuals who develop PUs beyond chance alone. AUCs
were also below the desired cutoff value of 0.7.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS