Ben Asher Kestin Shir, Israel Ariel, Leshem Eran, Milman Anat, Sabbag Avi, Goldengerg Ilan, Nof Eyal, Beinart Roy
Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel.
Department of Internal Medicine C, Meir Medical Center, Kfar-Saba 4428164, Israel.
J Clin Med. 2022 Dec 27;12(1):214. doi: 10.3390/jcm12010214.
(1) Background: Implantable cardioverter defibrillators (ICDs) have become the standard of care in the prevention of sudden cardiac death, yet studies have shown that competing causes of death may limit ICD benefits. The Norton scale is a pressure ulcer risk score shown to have prognostic value in other fields. The purpose of this study was to assess the use of the Norton scale as an aid for ICD patient selection; (2) Methods: The study was comprised of consecutive patients who underwent defibrillator implantation at Sheba Medical Center between 2008 and 2016. A competing risk analysis was performed to assess the likelihood of death prior to device therapy; (3) Results: 695 patients were included. A total of 59 (8.5%) patients had low admission Norton scale score (ANSS) (≤14), 81 (11.7%) had intermediate ANSS (15−17), and the remainder (79.8%) had high (18−20) ANSS. The cumulative probability of all-cause mortality within one year of ICD implantation in patients with low ANSS was 30%, compared with 20% and 7% among the intermediate- and high-ANSS groups, respectively. Moreover, the one-year mortality rate without ICD therapy in low-ANSS patients was over four-fold compared with that of high-ANSS patients (33% versus 7%, p < 0.0001); (4) Conclusions: The Norton scale could be a useful additional tool in predicting the life expectancy of ICD candidates, thereby improving patient selection.
(1) 背景：植入式心脏复律除颤器（ICD）已成为预防心源性猝死的标准治疗手段，但研究表明，其他死因可能会限制ICD的益处。诺顿量表是一种压疮风险评分，已证实在其他领域具有预后价值。本研究的目的是评估诺顿量表在ICD患者选择中的辅助作用；(2) 方法：本研究纳入了2008年至2016年期间在舍巴医疗中心接受除颤器植入的连续患者。进行了竞争风险分析，以评估在设备治疗前死亡的可能性；(3) 结果：共纳入695例患者。共有59例（8.5%）患者入院时诺顿量表评分低（ANSS）（≤14），81例（11.7%）患者ANSS中等（15 - 17），其余患者（79.8%）ANSS高（18 - 20）。低ANSS患者在ICD植入后一年内全因死亡率的累积概率为30%，而中等ANSS组和高ANSS组分别为20%和7%。此外，低ANSS患者在未接受ICD治疗时的一年死亡率是高ANSS患者的四倍多（33%对7%，p < 0.0001）；(4) 结论：诺顿量表可能是预测ICD候选者预期寿命的有用辅助工具，从而改善患者选择。
