Admission Norton scale scores are associated with long-term mortality following rehabilitation in older adults
Dan Justo , Noam Guy , Ehud Halperin, Yaffa Lerman
Objective: Low admission Norton scale scores (ANSS) are usually associated with high risk of pressure ulcer. The aim of this study was to determine whether low ANSS are also associated with long-term mortality following rehabilitation in older adults.
Design: A cross-sectional retrospective study.
Subjects: Consecutive older adults admitted during 2009 for rehabilitation following stroke (n = 110), hip arthroplasty (n = 201), and hospital-associated deconditioning (n = 96).
Methods: Patients were followed until January, 2011. Long-term mortality rates, i.e. within one year or more, were compared between patients with low (≤ 14) ANSS and patients with high (≥ 15) ANSS.
Results: The final cohort included 407 patients (67.8% females; mean age 82.2 years). Overall, 193 (47.4%) patients had low ANSS. Patients were followed for a mean period of 524 days. Overall, 66 (16.2%) patients died during this time. Patients who died had significantly lower mean ANSS compared with those who survived (13.9 vs 14.9; p = 0.001). Cumulative survival rates were significantly lower among patients with low ANSS compared with patients with high ANSS (p = 0.004). Regression analysis showed that ANSS were independently associated with mortality (p = 0.02), regardless of rehabilitation cause, age, gender, and chronic co-morbidities.
Conclusion: ANSS may be used not only for evaluating pressure ulcer risk, but also for predicting long-term mortality, i.e. within one year or more, following rehabilitation in older adults.
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