Spinal Cord Injury Pressure Ulcer Scale – Acute (SCIPUS-A)

Developed as a measure of the risk for pressure ulcer development for individuals with SCI during the acute phase of injury (within 30 days of admission).
Items for the scale were identified based on statistical analysis of data from 226 individuals with SCI, which compared development of pressure ulcers with demographic variables and 50 potential pressure ulcer risk factors. It evaluates eight domains:
1. Extent of paralysis
2. Moisture
3. Serum creatinine
4. Incontinence
5. Albumin
6. Mobility
7. Pulmonary disease
8. Level of activity

Clinical Considerations

The SCIPUS-A scale is a quick and easy to use measure that provides predictive information about risk of pressure sore development. Despite the good content validity, other validity evidence is only adequate, and there has been no reliability or responsiveness testing with these individuals with SCI.
Designed for individuals with SCI.
There is minimal burden related to administering or scoring the scale if tests for albumin and serum creatinine are already part of the patient’s medical record. Otherwise the blood tests required would be invasive and create respondent burden.

Body Functions ▶ Functions of the Skin

Clinician-administered; raters indicate client function status based on personal experience or chart review.
Response categories are either dichotomous (present/ absent (score = 1 to 2 or 0, respectively) or have 3 to 5 options. For example, for ‘extent of paralysis’ – absent (i.e. no paralysis) is awarded a score of 0, paraparesis: 1, quadriparesis: 4, paraplegia: 8 and quadriplegia: 10.

None

Scales are scored based on descriptive criteria provided on the scoring sheet.
As noted above, responses to each item are awarded a value between 0 to 1-10 and these are added together to create a summary score ranging from 0-25.

English

No advanced training required.

Can be found in the appendix of the following article: https://pubmed.ncbi.nlm.nih.gov/10326341/

# of studies reporting psychometric properties: 2

Lower scores equal better prognosis.
Sensitivity and specificity percentages are provided at a variety of cut-off scores.
No normative data has been established for the SCI population.
Published data for the SCI population is available for comparison (see Interpretability section of the Study Details sheet).

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

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

For the SCIPUS-A, the best balance point was found at a cut-off point of ≥18, which gave a sensitivity of 88.5% and a specificity of 59%. The SCIPUS-A (71%) was the most accurate in predicting pressure ulcer development, followed by the SCIPUS (65.9%), Braden (62.3%), Gosnell (62.2%), Abruzzese (60.1%) and Norton (60.8%) scales.
Correlation of the SCIPUS is moderate with the stage of the first pressure ulcer (Spearman’s r=0.488) and with the number of ulcers developed (Spearman’s r=0.519).

(Salzberg et al. 1999; Ash 2002)

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

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

Dr. Vanessa Noonan, Marzena Zhou, Risa Fox

3 August 2020

Ash D. An exploration of the occurrence of pressure ulcers in a British spinal injuries unit. J Clin Nurs 2002;11:470-478.
http://www.ncbi.nlm.nih.gov/pubmed/12100643

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

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