The Performance of the Scott Triggers™ Instrument in Predicting Perioperative Pressure Injury (PPI) Development

Area of Science:

• Surgical Patient Care
• Medical Device Performance Evaluation
• Risk Assessment in Healthcare

Background:

• Perioperative pressure injury (PPI) is a significant concern in surgical patients.
• Accurate prediction tools are crucial for implementing timely preventative measures.
• The Scott Triggers (ST) instrument's performance in predicting PPI requires further investigation.

Purpose of the Study:

• To evaluate the predictive performance of the Scott Triggers (ST) instrument for perioperative pressure injury (PPI) development.
• To assess the accuracy of the ST instrument in adult general surgical patients.
• To identify reliable predictors of PPI in the perioperative period.

Main Methods:

• Retrospective, exploratory study design.
• Analysis of medical records from adult patients undergoing inpatient non-cardiac surgery (January 2021 - June 2023).
• Psychometric assessment of the ST instrument using sensitivity, specificity, PPV, NPV, and ROC/AUC.

Main Results:

• The Scott Triggers (ST) instrument demonstrated lower predictive accuracy for PPI than previously reported (OR: 1.77).
• American Society of Anesthesiologists (ASA) score of 3 or higher was identified as a primary predictor of PPI (OR: 6.61 univariate, 6.30 multivariate).

Conclusions:

• The American Society of Anesthesiologists (ASA) score (≥3) is a reliable predictor of PPI risk in surgical patients.
• This finding provides perianesthesia nurses with a practical tool for initiating PPI preventative strategies.
• The ST instrument's utility in this specific population warrants further evaluation.