Purpose: To determine if low admission Norton scale scores (ANSS) are associated with medical complications other than pressure ulcers during rehabilitation in the elderly. Methods: A retrospective cohort study conducted in a department of geriatric rehabilitation during 2009. The medical charts of consecutive elderly (≥ 65 years) patients admitted for rehabilitation following hip arthroplasty (n = 221), stroke (n = 111), and due to hospital-associated deconditioning (HAD) (n = 98), were studied for the following measurements: ANSS, demographics, co-morbidities, the appearance of pressure ulcers, and medical complications. Medical complications included: urinary tract infection, soft tissue infection, respiratory tract infection, gastrointestinal infection, arthritis, falls, venous thromboembolism, gastrointestinal bleeding, urinary retention, heart failure exacerbation, acute renal failure, and transient confusion. Results: Four hundred and thirty patients were included: 289 (67.2%) females; mean age 82.3 ± 6.7 years. Overall, 132 (30.7%) patients had medical complications, and the three most common were: urinary tract infection, respiratory tract infection, and urinary retention. Mean ANSS was 14.6 ± 2.2, and 208 (48.4%) patients had low (≤ 14) ANSS. Patients with medical complications had significantly lower ANSS relative to patients without medical complications (13.7 ± 2.1 vs. 14.9 ± 2.1; P < 0.0001). Regression analysis showed that medical complications were independently associated with ANSS as a continuous variable (P = 0.022) and with low ANSS as a categorical variable (P = 0.034), regardless of age, gender, cause of rehabilitation, co-morbidities, admission albumin serum levels, mini-mental status examination scores, and the appearance of pressure ulcers. Conclusions: The Norton scoring system may be used for predicting medical complications other than pressure ulcers during rehabilitation in the elderly following hip arthroplasty, stroke, and with HAD.
- Norton scale
- Pressure ulcers