Spinal Cord Injury Pressure Ulcer Scale (SCIPUS) Measure

Download Clinical Summary PDF

Tool Description

  • Developed as a measure of the risk for pressure ulcer development for individuals with SCI who are in a rehabilitation centre.
  • Items for the scale were identified based on statistical analysis of data from 176 individuals with SCI, which compared development of pressure ulcers with demographic variables and potential pressure ulcer risk factors. Every patient is evaluated in fifteen domains:
    1) Level of activity
    2) Mobility
    3) Complete SCI
    4) Urine incontinence or constant moistness
    5) Autonomic dysreflexia or severe spasticity
    6) Age
    7) Tobacco use/smoking
    8) Pulmonary disease
    9) Cardiac disease
    10) Blood glucose levels: > 110 mg/dl
    11) Renal disease
    12) Impaired cognitive function
    13) In a nursing home or hospital
    14) Albumin < 3.4 or T, protein < 6.4
    15) Hematocrit <36.0%.
  • Most items are scored dichotomously as either present or absent, but 4 items have three response options.

ICF Domain:

Body Function – Subcategory: Functions of the Skin.

Number of Items:

15

Brief Instructions for Administration & Scoring

Administration:

  • Clinician-administered; raters indicate client status based on personal knowledge of the client or chart review.
  • Dichotomous items are given a weighted score of 0 when absent and 1 or 2 when present
  • Non dichotomous items are given a weighted score based on the descriptive criteria provided on the scoring sheet. For example, the presence of pulmonary disease (ICD codes 450, 460-519 & 796.0) = a score of 2.

Equipment: None.

Scoring:

  • By adding domain scores together a summary score is calculated.

Interpretability

MCID: not established in SCI
SEM: not established in SCI
MDC: not established in SCI

  • Scores range from 0 (best prognosis) to 25 (worst prognosis).
  • A cut off score of 6 has been suggested to indicate clients at risk for pressure ulcer development.

Languages:

n/a

Training Required:

None.

Availability:

Can be found in Salzberg et al. 1996 or at: http://www.rehabmeasures.org/Lists/RehabMeasures/DispForm.aspx?ID=962

Clinical Considerations

  • Although the SCIPUS is reported to be the best measure for individuals with SCI, the reliability of the scale has not been demonstrated with this population. The scale was developed specifically for use in rehabilitation centers and has not been tested in community dwelling populations.
  • There is minimal burden related to administering or scoring the scale if tests for diabetes, albumin and hemocrit are already part of the patient’s medical record.  Otherwise the blood tests required would be invasive and create respondent burden.

Measurement Property Summary

# of studies reporting psychometric properties: 2

Reliability:

No values have been reported for the reliability of the SCIPUS for the SCI population at this time.

Validity:

  • The optimal balance of sensitivity (75.6%) to specificity (74.4%) was found at a cut-off point of ≥6 for SCIPUS score. The positive predictive value was 92.4% and the negative predictive value was 42.7%.
  • Correlation of the SCIPUS is moderate with the stage of the first pressure ulcer (Spearman’s r=0.343) and with the number of ulcers developed (Spearman’s r=0.339).

[Salzberg et al. 1996, Salzberg et al. 1999]

Responsiveness:

No values have been reported for the responsiveness of the SCIPUS for the SCI population at this time.

Floor/ceiling effect:

No values were reported for the presence of floor/ceiling effects in the SCIPUS for the SCI population.

Reviewer

Dr. Vanessa Noonan, Jeremy Mak, John Zhu

Date Last Updated:

Mar 2, 2017

Download the measure

Download Worksheet:
Can be found in Salzberg et al. 1996 or at: http://www.rehabmeasures.org/Lists/RehabMeasures/DispForm.aspx?ID=962

Video

n/a

Scoring

n/a

Equipment Needed

SCIPUS:

Delparte JJ, Scovil CY, Flett HM, Higgins J, Laramée MT, Burns AS. Psychometric Properties of the Spinal Cord Injury Pressure Ulcer Scale (SCIPUS) for Pressure Ulcer Risk Assessment During Inpatient Rehabilitation. Arch Phys Med Rehabil. 2015;96(11):1980-5.
http://www.ncbi.nlm.nih.gov/pubmed/26205694

Salzberg CA, Byrne DW, Cayten CG, van Niewerburgh P, Murphy JG, Viehbeck M. A new pressure ulcer risk assessment scale for individuals with spinal cord injury. Am J Phys Med Rehabil 1996;75:96-104.
http://www.ncbi.nlm.nih.gov/pubmed/8630201

Salzberg CA, Byrne DW, Kabir R, van Niewerburg P, Cayten CG. Predicting pressure ulcers during initial hospitalization for acute spinal cord injury. Wounds 1999;11:45-57.
http://scholar.google.ca/scholar?hl=en&q=Predicting+pressure+ulcers+during+initial+hospitalization+for+acute+spinal+cord+injury&btnG=&as_sdt=1%2C5&as_sdtp=