Sever R, Sherman S, Rozen N, Chechik O, Hilu S, Abdelrazek S, Salai M, Justo D
Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
Z Gerontol Geriatr. 2015 Jun;48(4):365-9. doi: 10.1007/s00391-014-0812-9. Epub 2014 Sep 20.
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.
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.
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.
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).
The Norton scale can be used for predicting 1-year mortality in elderly patients following lower limb amputations.
诺顿量表用于评估压疮风险。迄今为止，尚未有研究探讨老年患者下肢截肢术后入院时诺顿量表低分（ANSS）与并发症及死亡率之间的关联。
本研究旨在调查老年患者下肢截肢术后低ANSS是否与30天及1年死亡率的并发症相关。
研究了104例老年（≥65岁）下肢截肢患者的病历，进行以下测量：ANSS、人口统计学、合并症、住院期间并发症、30天死亡率和1年死亡率。并发症包括急性冠状动脉综合征、大出血、中风、全身感染、器官衰竭和血栓栓塞。ANSS≤14被视为低分。
总体而言，54例（51.9%）患者接受了膝下截肢，50例（48.1%）患者接受了膝上截肢。大多数（n = 78；75.0%）患者为男性，平均年龄为78.5±7.9岁。截肢后，46例（44.2%）患者出现了除压疮以外的并发症，24例（23.1%）患者在30天内死亡，63例（60.6%）患者在1年内死亡。共有61例（58.7%）患者ANSS较低。与ANSS高的患者相比，ANSS低的患者除压疮以外的并发症发生率、30天和1年死亡率更高。回归分析显示，1年死亡率与ANSS独立呈负相关（t = 2.629；p = 0.010）。
诺顿量表可用于预测老年患者下肢截肢术后的1年死亡率。
