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Assessing the predictive validity of the Salzberg Scale during acute care and inpatient rehabilitation

Brick, Rachelle (2014) Assessing the predictive validity of the Salzberg Scale during acute care and inpatient rehabilitation. Undergraduate Thesis, University of Pittsburgh. (Unpublished)

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Pressure ulcers (PrU) are a leading secondary medical complication in the spinal cord injury (SCI) population. With over two hundred known risk factors, PrU prevention is extremely complex but can provide an astounding difference in a patient’s recovery. Multiple risk assessment scales allow us to quantify risk across a broad range of populations, yet the literature provides little evidence that these tools are representative of PrU development in the SCI population. The Pressure Ulcer Assessment Scale for the Spinal Cord Injured (Salzberg Scale) is a risk assessment scale specific to the SCI population, composed of fifteen risk factors that divide PrU development risk into four categories. The objective of this thesis is to assess the predictive validity of the Salzberg Scale during acute care and inpatient rehabilitation following spinal cord injury.
Data was extracted from a primary study on PrU outcomes for newly injured traumatic SCI patients in acute care and inpatient rehabilitation. A secondary analysis assigned subjects a raw Salzberg Scale score based on collected medical information and Salzberg Scale component definitions. The Salzberg scores were used to compute sensitivities, specificities, and accuracy of the scale with newly defined risk cut-off scores for acute hospitalization and inpatient rehabilitation.
Sensitivity and specificity were calculated for the scale’s ability to predict PrU ranging from two to 22 days after administration of the Salzberg Scale risk assessment tool. The use ofthe scale in the acute care hospitalization to assess risk for PrU within 2-3 days showed the only strong predictive results with an area under the curve (AUC) of 0.8482 at the indicated cutoff score of 15. The sensitivity of 100.0% and a specificity of 75.0%, showed a more accurate prediction balance than the validation study conducted by Salzberg on a broader population sample. Overall, failure of the scale’s predictive ability to predict a pressure ulcer over a longer time period suggests further studies must be completed in order for the scale be recommended for implementation in an inpatient rehabilitation setting.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairBrienza, Daviddbrienza@pitt.eduDBRIENZA
Committee MemberTzen, Yi-Tingyit10@pitt.eduYIT10
Committee MemberKarg, Patriciatkarg@pitt.eduTKARG
Committee MemberGarber,
Date: 1 May 2014
Date Type: Publication
Defense Date: 28 March 2014
Approval Date: 1 May 2014
Submission Date: 29 April 2014
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 76
Institution: University of Pittsburgh
Schools and Programs: David C. Frederick Honors College
School of Health and Rehabilitation Sciences > Rehabilitation Science
Degree: BPhil - Bachelor of Philosophy
Thesis Type: Undergraduate Thesis
Refereed: Yes
Uncontrolled Keywords: pressure ulcer, Salzberg Scale, spinal cord injury
Date Deposited: 01 May 2014 15:56
Last Modified: 15 Nov 2016 14:19


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