Skip to main content
Erschienen in: Zeitschrift für Gerontologie und Geriatrie 4/2015

01.06.2015 | Originalien

Norton scale scores and 1-year mortality in elderly patients following lower limb amputations

verfasst von: R. Sever, MD, S. Sherman, MD, N. Rozen, MD, O. Chechik, MD, S. Hilu, RN, S. Abdelrazek, RN, M. Salai, MD, Clin. Assoc. Prof. D. Justo, MD

Erschienen in: Zeitschrift für Gerontologie und Geriatrie | Ausgabe 4/2015

Einloggen, um Zugang zu erhalten

Abstract

Background

The Norton scale is used for assessing the risk of pressure ulcers. The association between low admission Norton scale scores (ANSS), complications and mortality in elderly patients following lower limb amputations has never been studied until now.

Objectives

The aim of this study was to investigate if low ANSSs are associated with complications the 30-day and 1-year mortality in elderly patients following lower limb amputations.

Materials and methods

The medical charts of 104 elderly (≥ 65 years) patients following lower limb amputations were studied for the following measurements: ANSS, demographics, comorbidities, complications during hospitalization, 30-day mortality and 1-year mortality. Complications included acute coronary syndrome, major bleeding, stroke, systemic infections, organ failure and thromboembolism. An ANSS ≤ 14 was considered as being low.

Results

Overall 54 (51.9 %) patients underwent below-knee amputations and 50 (48.1 %) patients underwent above-knee amputations. Most (n = 78; 75.0 %) patients were men and the mean age was 78.5 ± 7.9 years. Following the amputation 46 (44.2 %) patients had complications other than pressure ulcers, 24 (23.1 %) patients died within 30 days and 63 (60.6 %) patients died within 1 year. A total of 61 (58.7 %) patients had a low ANSS. The incidence of complications other than pressure ulcers, 30-day and 1-year mortality rates were higher in patients with a low ANSS relative to patients with a high ANSS. A regression analysis showed that 1-year mortality was independently negatively associated with ANSS (t = −2.629; p = 0.010).

Conclusion

The Norton scale can be used for predicting 1-year mortality in elderly patients following lower limb amputations.
Literatur
1.
Zurück zum Zitat Norton D (1989) Calculating the risk: reflections on the Norton scale. Decubitus 2:24–31PubMed Norton D (1989) Calculating the risk: reflections on the Norton scale. Decubitus 2:24–31PubMed
2.
Zurück zum Zitat Global Lower Extremity Amputation Study Group (2000) Epidemiology of lower extremity amputation in centres in Europe, North America and East Asia. The Global Lower Extremity Amputation Study Group. Br J Surg 87:328–337CrossRef Global Lower Extremity Amputation Study Group (2000) Epidemiology of lower extremity amputation in centres in Europe, North America and East Asia. The Global Lower Extremity Amputation Study Group. Br J Surg 87:328–337CrossRef
3.
Zurück zum Zitat Carmona GA, Hoffmeyer P, Herrmann FR, Vaucher J, Tschopp O et al (2005) Major lower limb amputations in the elderly observed over ten years: the role of diabetes and peripheral arterial disease. Diabetes Metab 31:449–454PubMedCrossRef Carmona GA, Hoffmeyer P, Herrmann FR, Vaucher J, Tschopp O et al (2005) Major lower limb amputations in the elderly observed over ten years: the role of diabetes and peripheral arterial disease. Diabetes Metab 31:449–454PubMedCrossRef
4.
Zurück zum Zitat Bates BE, Xie D, Kurichi JE, Cowper Ripley D, Kwong PL, Stineman MG (2012) Revisiting risks associated with mortality following initial transtibial or transfemoral amputation. J Rehabil Res Dev 49:1479–1492PubMedCentralPubMedCrossRef Bates BE, Xie D, Kurichi JE, Cowper Ripley D, Kwong PL, Stineman MG (2012) Revisiting risks associated with mortality following initial transtibial or transfemoral amputation. J Rehabil Res Dev 49:1479–1492PubMedCentralPubMedCrossRef
5.
Zurück zum Zitat Kurichi JE, Stineman MG, Kwong PL, Bates BE, Reker DM (2007) Assessing and using comorbidity measures in elderly veterans with lower extremity amputations. Gerontology 53:255–259PubMedCentralPubMedCrossRef Kurichi JE, Stineman MG, Kwong PL, Bates BE, Reker DM (2007) Assessing and using comorbidity measures in elderly veterans with lower extremity amputations. Gerontology 53:255–259PubMedCentralPubMedCrossRef
6.
Zurück zum Zitat Norton D, McLaren R, Exton-Smith AN (1962) An investigation of geriatric nursing problems in the hospital. National Corporation for the care of old people, London Norton D, McLaren R, Exton-Smith AN (1962) An investigation of geriatric nursing problems in the hospital. National Corporation for the care of old people, London
7.
Zurück zum Zitat Gold A, Sever R, Lerman Y, Salai M, Justo D (2011) Admission Norton scale scores (ANSS) and postoperative complications following hip fracture surgery in the elderly. Arch Gerontol Geriatr 55:173–176PubMedCrossRef Gold A, Sever R, Lerman Y, Salai M, Justo D (2011) Admission Norton scale scores (ANSS) and postoperative complications following hip fracture surgery in the elderly. Arch Gerontol Geriatr 55:173–176PubMedCrossRef
8.
Zurück zum Zitat Asleh K, Sever R, Hilu S, Ron R, Gold A et al (2012) Association between low admission Norton scale scores and postoperative complications after elective THA in elderly patients. Orthopedics 35:e1302–e1306PubMedCrossRef Asleh K, Sever R, Hilu S, Ron R, Gold A et al (2012) Association between low admission Norton scale scores and postoperative complications after elective THA in elderly patients. Orthopedics 35:e1302–e1306PubMedCrossRef
9.
Zurück zum Zitat Sever R, Gold A, Segal O, Regev G, Keynan O et al (2011) Admission Norton scale scores (ANSS) are associated with post-operative complications following spine fracture surgery in the elderly. Arch Gerontol Geriatr 55:177–180PubMedCrossRef Sever R, Gold A, Segal O, Regev G, Keynan O et al (2011) Admission Norton scale scores (ANSS) are associated with post-operative complications following spine fracture surgery in the elderly. Arch Gerontol Geriatr 55:177–180PubMedCrossRef
11.
Zurück zum Zitat Tendera M, Aboyans V, Bartelink ML, Baumgartner I, Clement D et al (2011) ESC Guidelines on the diagnosis and treatment of peripheral artery diseases. Eur Heart J 32:2851–2906PubMedCrossRef Tendera M, Aboyans V, Bartelink ML, Baumgartner I, Clement D et al (2011) ESC Guidelines on the diagnosis and treatment of peripheral artery diseases. Eur Heart J 32:2851–2906PubMedCrossRef
14.
Zurück zum Zitat Bååth C, Hall-Lord ML, Idvall E, Wiberg-Hedman K, Wilde Larsson B (2008) Interrater reliability using Modified Norton Scale, Pressure Ulcer Card, Short Form-Mini Nutritional Assessment by registered and enrolled nurses in clinical practice. J Clin Nurs 17:618–626 Bååth C, Hall-Lord ML, Idvall E, Wiberg-Hedman K, Wilde Larsson B (2008) Interrater reliability using Modified Norton Scale, Pressure Ulcer Card, Short Form-Mini Nutritional Assessment by registered and enrolled nurses in clinical practice. J Clin Nurs 17:618–626
15.
Zurück zum Zitat Harris PL, Read F, Eardley A, Charlesworth D, Wakefield J, Sellwood RA (1974) The fate of elderly amputees. Br J Surg 61:665–668PubMedCrossRef Harris PL, Read F, Eardley A, Charlesworth D, Wakefield J, Sellwood RA (1974) The fate of elderly amputees. Br J Surg 61:665–668PubMedCrossRef
16.
Zurück zum Zitat Remes L, Isoaho R, Vahlberg T, Hiekkanen H, Korhonen K et al (2008) Major lower extremity amputation in elderly patients with peripheral arterial disease: incidence and survival rates. Aging Clin Exp Res 20:385–393PubMedCrossRef Remes L, Isoaho R, Vahlberg T, Hiekkanen H, Korhonen K et al (2008) Major lower extremity amputation in elderly patients with peripheral arterial disease: incidence and survival rates. Aging Clin Exp Res 20:385–393PubMedCrossRef
Metadaten
Titel
Norton scale scores and 1-year mortality in elderly patients following lower limb amputations
verfasst von
R. Sever, MD
S. Sherman, MD
N. Rozen, MD
O. Chechik, MD
S. Hilu, RN
S. Abdelrazek, RN
M. Salai, MD
Clin. Assoc. Prof. D. Justo, MD
Publikationsdatum
01.06.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Zeitschrift für Gerontologie und Geriatrie / Ausgabe 4/2015
Print ISSN: 0948-6704
Elektronische ISSN: 1435-1269
DOI
https://doi.org/10.1007/s00391-014-0812-9

Weitere Artikel der Ausgabe 4/2015

Zeitschrift für Gerontologie und Geriatrie 4/2015 Zur Ausgabe

Mitteilungen der DGG

Mitteilungen der DGG

Mitteilungen des Bundesverbands Geriatrie

Mitteilungen des Bundesverbands Geriatrie

Journal Club

Journal Club

Mitteilungen der ÖGGG

Mitteilungen der ÖGGG

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.