Low admission Norton scale scores are associated with falls long after rehabilitation in the elderly with hip fractures.

BACKGROUND: In this study, we investigated if low admission Norton scale scores (ANSS) are associated with falls, fractures, hospitalizations, and death, after rehabilitation in the elderly with hip fractures. METHODS: This prospective historical study followed consecutive elderly patients (≥65 years) who were admitted for rehabilitation following hip fracture surgery during 2009 and followed up in January or February 2012. The incidence of falls, number of falls, incidence of fractures, number of hospitalizations, and death rates were compared between patients with low (≤14) and high (≥15) ANSS. RESULTS: The final cohort included 174 patients of mean age 83.6 ± 6.2 years, with 133 (76.4%) being women. Fifty-seven (27.0%) patients died during follow-up. Of the remaining 127 patients, 44 (34.6%) fell at least once and 15 (11.8%) suffered fractures. Overall, 81 (46.6%) patients had a low ANSS. Relative to patients with a high ANSS, they had a higher incidence of falls (odds ratio 3.3, 95% confidence interval 1.5-7.1; P = 0.002) and fell more times (1.2 ± 1.8 versus 0.6 ± 1.7; P = 0.002). Regression analysis showed that ANSS (as a parametric variable) as well as a low ANSS (as a nonparametric variable) were independently associated with falls (P = 0.002 and P = 0.009, respectively). There were no differences between patients with low and high ANSS in terms of incidence of fractures, number of hospitalizations, and death rates. CONCLUSION: The Norton scoring system may be used for predicting falls long after rehabilitation in the elderly with hip fractures.

Admission Norton scale scores are associated with long-term mortality following rehabilitation in older adults.

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.