Admission Norton scale scores correlate with rehabilitation outcome and length in elderly patients following cerebrovascular accident

Aims: To determine whether Norton scale scores used for evaluating pressure sore risk also correlate with rehabilitation outcome and length following cerebrovascular accident (CVA) in elderly patients. Methods: A retrospective study was conducted at a geriatric rehabilitation department in a tertiary medical center during 2009. The medical charts of consecutive elderly (≥65 years) patients admitted for rehabilitation after CVA were studied for the following measurements: admission Norton scale scores, admission albumin serum levels, mini-mental status examination (MMSE) scores, discharge walking functional independence measure (FIM) scores, discharge transfer FIM scores, and rehabilitation length in days. Results: The cohort included 110 patients, 64 (58.2%) women and 46 (41.8%) men. The mean age of the entire group was 80.5±7.4 years. Most patients had ischemic CVA (90.9%) and a first CVA (79.1%). The mean discharge walking FIM score was 4.7±1.4, the mean discharge transfer FIM score was 5.0±1.4, and the mean length of rehabilitation was 28.2±15.3 days. Admission Norton scale scores correlated with discharge walking FIM scores (r=0.51; p<0.0001), discharge transfer FIM scores (r=0.43; p<0.0001), and length of rehabilitation (r=-0.45; p<0.0001) after adjustment for age, albumin serum levels, and MMSE scores. Linear regression analysis showed that admission Norton scale scores were associated (p<0.0001) with the discharge walking FIM scores, the discharge transfer FIM scores and rehabilitation length, independent of age, gender, albumin serum levels, MMSE scores, type of CVA, and the appearance of pressure sores. Conclusions: The Norton scoring system may be used to predict the outcome and duration of rehabilitation in elderly patients after CVA.