The reliability and validity of the Scott Triggers for patients in China undergoing gastrointestinal surgery

Scott Triggers is designed to identify potential surgical patients at risk for development of pressure injuries. But it has not been validated for sensitivity and positive predictive value to date. This study aimed to evaluate the reliability and validity of the Scott Triggers for the gastrointestinal surgery patients in China.

447 gastrointestinal surgery patients were enrolled by convenience sampling and investigated by Scott Triggers from March to November 2019.

8 patients (1.780%) develop pressure injuries. The Cronbach's alpha was 0.701 and the interrater reliability was 0.915. The content validity of each item of Scott Triggers ranged from 0.667 to 1.0 and the content validity of the whole scale was 0.832, which showed a significant positive relationship and good internal consistent validity. The accumulative variance contribution ratio of common factor was 53.194%. Pearson correlation between Scott Triggers and 3S intraoperative risk assessment scale was -0.708 (P < 0.001). The Youden index was 0.374, the optimal predictive threshold of Scott Triggers was 5.5, the area under receiver operating characteristic (ROC) curve was 0.762, the sensitivity was 0.875, the specificity was 0.499, the positive predictive value was 0.027, and the negative predictive value was 0.996.

Scott Triggers shows good reliability, validity, and predictive validity in this study, which can be used to assess the risk of stress injury in surgical patients. However, the body mass index needs to be taken into account in further study.