Norton scale score on admission and mortality of patients hospitalized in internal medicine departments

Díez-Manglano, Jesús; Arnal-Longares, M.J.; Al-Cheikh-Felices, P.; Garcés-Horna, V.; Pueyo-Tejedor, P.; Martínez-Rodés, P.; Díez-Massó, F.; Rubio-Félix, S.; Corral-Beamonte, Esther Del; Palazón-Fraile, C.

doi:10.1016/j.rceng.2018.02.006

Cited by 4 publications

(2 citation statements)

References 20 publications

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“…The mean NSS among patients who died was a low 9.2, whereas the mean NSS of the entire cohort was 16. This is consistent with previous data that demonstrated the association between low NSS and mortality during hospitalization [ 27 , 28 ]. In addition to a very low NSS, patients who died were very old, and five of the seven were transferred to the intensive care unit or medical department after being initially hospitalized in surgery.…”

Section: Discussionsupporting

confidence: 94%

Characteristics and outcome of elderly patients admitted for acute Cholecystitis to medical or surgical wards

Feldman

Shapiro

et al. 2020

Isr J Health Policy Res

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Background Elderly patients admitted because of acute cholecystitis are usually not operated during their initial admission and receive conservative treatment. To help formulate a new admission policy regarding elderly patients with acute cholecystitis we compared the demographic and clinical characteristics and outcome of patients > 65 with acute cholecystitis admitted to medical or surgical wards. Methods This retrospective study included all patients > 65 years admitted for acute cholecystitis between January, 2009 and September, 2016. Data were retrieved from the electronic health records. Results A total of 187 patients were detected, 54 (29%) in medical departments and 133 (71%) in surgical wards. The mean age (±SD) was 80 ± 7.5 and was higher among those in medical than surgical wards (84 ± 7 versus 79 ± 7, p < 0.05). Patients hospitalized in medical departments had more comorbidity, disability and mental impairment. However, there was no difference in mortality between the two groups, 1 (2%) and 6 (4%) respectively. Independent predictors for hospitalization in medical departments were chronic obstructive pulmonary disease (OR = 9.8, 95% C. I 1.6–59) and the Norton Scale score (NSS)(OR = 0.7, 95% C. I 0.7–0.8). Impaired mental condition was the only predictor for hospitalization > 1 week. The strongest predictor for having cholecystostomy was admission to the surgical department (OR = 14.7, 95% C. I 3.9–56.7). Linear regression showed a negative correlation between NSS and length of hospitalization (LOH; Beta = − 0.5). Conclusion Elderly patients with acute cholecystitis who require conservative management, especially those with severe functional and mental impairment can be safely hospitalized in medical departments. Outcome was not inferior in terms of mortality and LOH. These results have practical policy implications for the placement of elderly patients with acute cholecystitis in medical rather than surgical departments.

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Section: Discussionsupporting

confidence: 94%

Characteristics and outcome of elderly patients admitted for acute Cholecystitis to medical or surgical wards

Feldman

Shapiro

et al. 2020

Isr J Health Policy Res

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“…Since it was first introduced, almost sixty years ago, the admission Norton scale score has been evaluated as prognostic scoring system in various medical conditions [2,3]. Díez-Manglano et al [4] found the Norton scale to be a useful predictor of both short-and long-term mortality among patients admitted to an internal medicine department. Recently, low Norton score (defined as below 16) was found to be associated with increased mortality in patients undergoing transcatheter aortic valve replacement [5] and with increased morbidity and mortality following acute myocardial infarction [6].…”

Section: Introductionmentioning

confidence: 99%

Norton score and clinical outcomes following acute decompensated heart failure hospitalization

Natanzon

Maor

Klempfner

et al. 2020

Journal of Cardiology

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Background: Norton scoring system is used to assess frailty of hospitalized patients with various medical conditions. We aimed to evaluate whether admission Norton scoring system predicts adverse outcomes among heart failure patients. Methods: The study population comprised 4388 acute heart failure patients between the years 2008 and 2017. Patients were allocated to 3 groups according to their admission Norton score [( 15-low, 16-18intermediate, and !19-high)]. Primary outcome included all-cause mortality at 30, 90 days, and 1 year. Multivariate Cox proportional hazards regression modeling was used to assess the independent association between Norton score and mortality. Net reclassification improvement (NRI) analysis was used to asses Norton's additive predictive ability upon known prognostic factors. Results: Among 4388 study patients, 32% (n = 1611) had low Norton score, 28% (n = 1384) intermediate score, and 40% (n = 1900) high score. Kaplan-Meier analysis demonstrated significantly higher 30-day mortality among patients with a low Norton score as compared with those with intermediate or high score (2.6%, 6.3%, and 16.1%; log rank p < 0.001). A similar trend was noted at 90 days and 1 year. Multivariate analysis found Norton score to be an independent predictor of mortality with each one-point decrement associated with a significant 15% increased risk for 30-day mortality [HR = 1.15 (95% CI, 1.12-1.17) p < 0.001]. NRI analysis showed an improvement of 21.5% (95%CI 18.3-25.1%) predicting 1-year mortality. Conclusion: Our findings show that the admission Norton score is a powerful marker of short-and long-term mortality. These data suggest that the scale should be added as a risk stratification tool in this high-risk population.

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The Norton scale is an important predictor of in-hospital mortality in internal medicine patients

et al. 2022

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Norton scale score on admission and mortality of patients hospitalized in internal medicine departments

Cited by 4 publications

References 20 publications

Characteristics and outcome of elderly patients admitted for acute Cholecystitis to medical or surgical wards

Characteristics and outcome of elderly patients admitted for acute Cholecystitis to medical or surgical wards

Norton score and clinical outcomes following acute decompensated heart failure hospitalization

The Norton scale is an important predictor of in-hospital mortality in internal medicine patients

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