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Determining Pressure Injury Risk on Admission to Inpatient Spinal Cord Injury Rehabilitation: A Comparison of the FIM, Spinal Cord Injury Pressure Ulcer Scale, and Braden Scale.
Flett, Heather M; Delparte, Jude J; Scovil, Carol Y; Higgins, Johanne; Laramée, Marie-Thérèse; Burns, Anthony S.
Afiliación
  • Flett HM; Brain and Spinal Cord Rehabilitation Program, Lyndhurst Centre, Toronto Rehabilitation Institute, University Health Network, Toronto, ON; Department of Physical Therapy, University of Toronto, Toronto, ON. Electronic address: heather.flett@uhn.ca.
  • Delparte JJ; Brain and Spinal Cord Rehabilitation Program, Lyndhurst Centre, Toronto Rehabilitation Institute, University Health Network, Toronto, ON.
  • Scovil CY; Brain and Spinal Cord Rehabilitation Program, Lyndhurst Centre, Toronto Rehabilitation Institute, University Health Network, Toronto, ON; Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, ON.
  • Higgins J; Research Unit, Integrated University Centre for Health and Social Services for South Central Island of Montreal-Institute of Rehabilitation Gingras-Lindsay-de-Montréal, Montreal, QC; School of Rehabilitation Faculty of Medicine, University of Montreal, Montreal, QC; Center for Interdisciplinary Rese
  • Laramée MT; Research Unit, Integrated University Centre for Health and Social Services for South Central Island of Montreal-Institute of Rehabilitation Gingras-Lindsay-de-Montréal, Montreal, QC; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal, QC; Spinal Cord Injury Program
  • Burns AS; Brain and Spinal Cord Rehabilitation Program, Lyndhurst Centre, Toronto Rehabilitation Institute, University Health Network, Toronto, ON; Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON, Canada.
Arch Phys Med Rehabil ; 100(10): 1881-1887, 2019 10.
Article en En | MEDLINE | ID: mdl-31054293
OBJECTIVE: Assess the utility of the admission Spinal Cord Injury Pressure Ulcer Scale (SCIPUS), Braden Scale, and the FIM for identifying individuals at risk for developing pressure injury during inpatient spinal cord injury (SCI) rehabilitation. DESIGN: Retrospective cohort. SETTING: Two tertiary rehabilitation centers. PARTICIPANTS: Individuals (N=754) participating in inpatient SCI rehabilitation. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Logistic regression analysis was performed to determine the utility of the SCIPUS, Braden Scale, and FIM for identifying individuals at risk for developing pressure injury (PI) during inpatient SCI rehabilitation. Sensitivity, specificity, positive predictive value, negative predictive value, false negative rate, odds ratio, likelihood ratio, and area under the curve (AUC) are reported. RESULTS: The SCIPUS total score and its individual items did not demonstrate acceptable accuracy (AUC≥0.7) whereas the Braden Scale (0.73) and the FIM score (0.74) did. Once items were dichotomized into high and low risk categories, 1 Braden item (friction and shear), 5 FIM items (bathing, toileting, bed/chair transfer, tub/shower transfer, toilet transfer), the FIM transfers subscale, FIM Motor subscale, and the FIM instrument as a whole, maintained AUCs ≥0.7 and negative predictive values ≥0.95. The FIM bed/chair transfer score demonstrated the highest likelihood ratio (2.62) and overall was the most promising measure for determining PI risk. CONCLUSION: Study findings suggest that a simple measure of mobility, admission FIM bed/chair transfer score of 1 (total assist), can identify at-risk individuals with greater accuracy than both an SCI specific instrument (SCIPUS) and a PI specific instrument (Braden). The FIM bed/chair transfer score can be readily determined at rehabilitation admission with minimal administrative and clinical burden.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Traumatismos de la Médula Espinal / Medición de Riesgo / Úlcera por Presión / Hospitalización Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Arch Phys Med Rehabil Año: 2019 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Traumatismos de la Médula Espinal / Medición de Riesgo / Úlcera por Presión / Hospitalización Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Female / Humans / Male / Middle aged País/Región como asunto: America do norte Idioma: En Revista: Arch Phys Med Rehabil Año: 2019 Tipo del documento: Article Pais de publicación: Estados Unidos