Asleh Karama, Sever Ronen, Hilu Sylvi, Ron Rachel, Gold Aviram, Aharon Menahem, Salai Moshe, Justo Dan
Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Orthopedics. 2012 Sep;35(9):e1302-6. doi: 10.3928/01477447-20120822-13.
The Norton scoring system is used by nurses to evaluate pressure ulcer risk. The authors have previously shown that low admission Norton scale scores (ANSS) are associated with postoperative complications other than pressure ulcers following hip fracture and spine fracture surgery in elderly patients. The purpose of this retrospective, cross-sectional study study was to determine whether low ANSS are associated with postoperative complications other than pressure ulcers following elective total hip arthroplasty (THA) in elderly patients. The medical charts of consecutive elderly (older than 65 years) patients admitted between February 2008 and November 2010 were studied for acute renal failure, cardiovascular events, confusion, pneumonia, pressure ulcers, urinary infection, urinary retention, venous thromboembolism, wound infection, and other complications. The final cohort included 166 patients (108 [65.1%] women; aged 75.2±6.4 years). Overall, 24 (14.5%) patients had low (16 or less) ANSS. Patients with low ANSS had significantly more postoperative complications other than pressure ulcers compared with patients with high ANSS (0.5±0.7 vs 0.2±0.4, respectively; P=.018). Binary regression analysis showed that low ANSS were independently associated with all postoperative complications other than pressure ulcers (P=.039). In addition to predicting pressure ulcer risk, the Norton scoring system may be used for predicting other postoperative complications in elderly patients following elective THA.
护士使用诺顿评分系统来评估压疮风险。作者此前已表明，老年患者髋部骨折和脊柱骨折手术后，入院时诺顿量表评分（ANSS）较低与除压疮外的术后并发症相关。这项回顾性横断面研究的目的是确定老年患者择期全髋关节置换术（THA）后，低ANSS是否与除压疮外的术后并发症相关。对2008年2月至2010年11月期间连续入院的老年（65岁以上）患者的病历进行研究，以了解急性肾衰竭、心血管事件、意识模糊、肺炎、压疮、尿路感染、尿潴留、静脉血栓栓塞、伤口感染及其他并发症情况。最终队列包括166例患者（108例[65.1%]为女性；年龄75.2±6.4岁）。总体而言，24例（14.5%）患者的ANSS较低（16分或更低）。与ANSS较高的患者相比，ANSS较低的患者除压疮外的术后并发症明显更多（分别为0.5±0.7和0.2±0.4；P = 0.018）。二元回归分析显示，低ANSS与除压疮外的所有术后并发症独立相关（P = 0.039）。除了预测压疮风险外，诺顿评分系统还可用于预测老年患者择期THA后的其他术后并发症。
