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

Shimoni, Zvi; Dusseldorp, Natan; Cohen, Yael; Barnisan, Izack; Froom, Paul

doi:10.1007/s11845-022-03250-0

Cited by 5 publications

(6 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, we did not include either the mobility and incontinence scales that have been shown in two studies not to add to models predicting in-hospital and short-term mortality after discharge. 11,15 The advantages of this simple frailty index are the ready availability of the variables on admission, its use of cut-of values that permit implementation in other settings, its inclusion of acute admissions only without intensive care or electively admitted patients, and its exclusion of physiological measurements, other more complicated nutritional or functional scales, or social and demographic data except for age and sex. Furthermore, the ndings were consistent over a 2-year period regardless of sex or disease category.…”

Section: Discussionmentioning

confidence: 99%

“…12 It includes ve domains; each domain is a fundamental aspect of health in the elderly: physical condition, mental condition, activity, mobility, and incontinence. 13 However, the Norton scale requires nurses to make value judgments on the grades of frailty for each domain, and furthermore the mobility scales and incontinence scales have not been shown to be associated with inhospital mortality 11 or 6-month mortality after discharge. 14 Therefore, we hypothesize that a fourcomponent scale including only yes/no assessments of three of the ve Norton scale domains shown to be associated with patient mortality, along with the presence or absence of a urinary catheter on admission will predict in-hospital mortality as well or better than the Norton scale.…”

Section: Introductionmentioning

confidence: 99%

“…Both the Norton scale 11 and the presence of a urinary catheter 12 are independent predictors of in-hospital mortality in acutely hospitalized adults in internal medicine departments. The Norton scale has been used by nurses around the world since the early 1960s to assess the risk of pressure ulcers upon admission and during hospitalization.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A Simple Frailty Index Predicts in-hospital Mortality

Shimoni,

Dusseldorp,

Cohen

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

INTRODUCTION: A frailty model that predicts in-hospital mortality is important to compare different settings and perhaps to modify patient disposition and treatment. We attempt to determine (a) if a new scale (Laniado-4 scale) that includes only three yes/no questions derived from the Norton scale and the presence of a urinary catheter performs as well as the graded Norton scale (including all five domains), in predicting in-hospital mortality and (b) to determine the predictive value of a simple frailty index that includes the new scale as well as categories of age, serum albumin, and creatinine values. METHODS: The study cohort included all acutely admitted adult patients in 2020–2021 to the three internal medicine departments at a regional 400-bed hospital. We calculated odds ratios with 95% confidence intervals and c-statistics for the various models predicting in-hospital mortality. RESULTS: The mean patient age was 73 ± 19 years, and 49.1% (5665/11542) were males. The Laniado-4 scale performed better than the Norton scale for predicting in-hospital mortality. A simple frailty index ranging from 0 to ≥ 8 points was associated with rates of in-hospital mortality that increased from 0 to 37.7%, with an odds ratio of 2.13(2.03–2.25) per 1 index point. The c-statistic was 0.887(0.881–0.893). CONCLUSIONS. We conclude the Laniado-4 scale performed better than the Norton scale in predicting in-hospital mortality, and that a simple frailty index including the 4-question scale as well as categories of age, serum creatinine, and serum albumin performed as well or better than more complicated models.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Simple Frailty Index Predicts in-hospital Mortality

Shimoni,

Dusseldorp,

Cohen

et al. 2023

Preprint

Self Cite

View full text Add to dashboard Cite

show abstract

“…(1) Background information on the study units: a protocol to prevent PIs in use (yes/no), a protocol to conduct skin assessment within 8 h after admission in use (yes/no), a PI risk assessment instrument in use (e.g., Braden Scale [ 21 ], Norton Scale [ 22 ], no instrument in use), an instrument to assess the risk of malnutrition in use (e.g., NRS2002 [ 23 ], no instrument in use), number of hospital beds and inpatients on data collection days. This information was collected from the nurse managers.…”

Section: Methodsmentioning

confidence: 99%

“…The result of the assessment was recorded on a data-collecting form, along with the stages and anatomical locations of the observed PI(s). Pressure injuries were staged by using the quick guide for PI staging by the Finnish Wound Care Society, which followed the guidelines of the National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel, and Pan Pacific Pressure Injury Alliance (NPUAP/EPUAP/PPPIA) that were present at the time of the study [ 22 ]. According to the quick guide, the PI stages included stages I-IV, mucous membrane PIs, non-visible PIs, and further, unstageable, and suspected deep tissue injuries as one class.…”

Section: Methodsmentioning

confidence: 99%

Nursing interventions in preventing pressure injuries in acute inpatient care: a cross-sectional national study

Tervo‐Heikkinen¹,

Heikkilä²,

Koivunen³

et al. 2023

BMC Nurs

View full text Add to dashboard Cite

Background Several nursing interventions for pressure injury prevention have been identified, including risk and skin status assessment. The aim of this study was to explore prevention of pressure injuries in Finnish acute inpatient care. The data were collected on pressure injury risk and skin status assessments, repositioning, the use of support surfaces, preventive skin care, malnutrition risk assessment, and nutritional care. Methods This multicentre, cross-sectional study was conducted in 16 acute care hospitals, excluding psychiatric care. Adult patients from inpatient care were recruited on the annual international Stop Pressure Ulcers Day in 2018 and 2019. Enrolment covered 6,160 participants in 503 units. Descriptive statistics were used to describe pressure injuries, risk assessments, and preventive nursing interventions. Cross tabulation, Pearson’s chi-square and Fisher’s exact tests were also used. Reporting follows the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Results In all, 30% of the participants had their pressure injury risk assessed during the care, and for 19% within 8 h after admission. The same time limit in risk assessment was fulfilled for 16% of the participants with a pressure injury, and 22% of the participants using a wheelchair or being bedridden. A skin status assessment within 8 h after admission was conducted for 30% of all participants, and for 29% of the participants with a pre-existing pressure injury, and for 38% of the participants using a wheelchair or being bedridden. The risk of malnutrition was screened in 20% of the participants. Preventive interventions were targeted to participants with a pressure injury instead of patients with a high-pressure injury risk. Conclusion This study adds evidence about pressure injury risk assessments and the implementation of preventive nursing interventions in Finnish acute care. Skin status and pressure injury risk assessments were irregularly conducted, and the outcome was not used by nurses to guide the implementation of preventive interventions. The results reveal the gaps in evidence-based nursing practice, which require further efforts to prevent pressure injuries. Improving the national focus on pressure injury prevention practice is critical for improving healthcare for our patients.

show abstract

A Simple Frailty Index Predicts Inhospital Mortality

Shimoni,

Dusseldorp,

Cohen

et al. 2024

Gerontology

View full text Add to dashboard Cite

Introduction: Comparing frailty models in different settings that predict inhospital mortality might modify patient disposition and treatment, but models are often complex. Methods: In the following study, we selected all acutely admitted adult patients in 2020–2021 to the three internal medicine departments at a regional 400-bed hospital. We attempt to determine (a) if a new scale (Laniado-4 scale) that includes only three yes/no questions derived from the Norton scale and the presence of a urinary catheter performs as well as the graded Norton scale (including all five domains), in predicting inhospital mortality and (b) to determine the predictive value of a simple frailty index that includes the new scale as well as categories of age, serum albumin, and creatinine values. We calculated odds ratios with 95% confidence intervals and c-statistics for the various models predicting inhospital mortality. Results: The mean patient age was 73 ± 19 years, and 49.1% (5,665/11,542) were males. A Laniado-4 scale performed better than the Norton scale for predicting inhospital mortality. A simple frailty index ranging from 0 to ≥8 points was associated with rates of inhospital mortality that increased from 0 to 37.7%, with an odds ratio of 2.13 (2.03–2.25) per 1 index point. The c-statistic was 0.887 (0.881–0.893). Conclusions: We conclude the Laniado-4 scale performed better than the Norton scale in predicting inhospital mortality and that a simple frailty index that included the 4-question scale and categories of age, serum creatinine, and serum albumin performed as well or better than more complicated models.

show abstract

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

Cited by 5 publications

References 27 publications

A Simple Frailty Index Predicts in-hospital Mortality

A Simple Frailty Index Predicts in-hospital Mortality

Nursing interventions in preventing pressure injuries in acute inpatient care: a cross-sectional national study

A Simple Frailty Index Predicts Inhospital Mortality

Contact Info

Product

Resources

About