Pressure ulcers develop in more than a third of spinal cord injured patient
s during their initial hospitalization. Because more than 200 risk factors
have been reported for pressure ulcers, practical application of this infor
mation is difficult. Although the Braden Scale is often used to assess the
risk of pressure ulcers, it was not developed for patients with spinal cord
injuries and has not been proven an accurate predictor in this population.
Although there is a Spinal Cord Injury Pressure Ulcer Scale (SCIPUS), it w
as designed to be used after the initial hospitalization. To assess the pre
diction of early pressure ulcers, we analyzed data on 226 patients hospital
ized for spinal cord injuries and evaluated five of the existing pressure u
lcer scales. The data showed that of the general-purpose scales, the Braden
Scale was most accurate. However, SCIPUS was more accurate than the Braden
Scale. Using modified cutoff points and the additional risk factors of ext
ent of paralysis, serum albumin, and serum creatinine, a new acute version
of SCIPUS was designed specifically for the initial hospitalization followi
ng a spinal cord injury, which we refer to as SCIPUS-A. Our results suggest
that this new scale is an accurate predictor of pressure ulcers during the
first hospitalization after a spinal cord injury. This information should
be useful in prioritizing today's limited health care resources in the most
cost-effective manner to reduce the incidence of pressure ulcers after a s
pinal cord injury.