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

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A Correction to this article was published on 24 December 2022

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Abstract

Background

The Norton scale, a marker of patient frailty used to predict the risk of pressure ulcers, but the predictive value of the Norton scale for in-hospital mortality after adjustment for a wide range of demographic, and abnormal admission laboratory test results shown in themselves to have a high predictive value for in-hospital mortality is unclear.

Aim

The study aims to determine the value of the Norton scale and the presence of a urinary catheter in predicting in hospital mortality.

Methods

The study population included all acutely admitted adult patients in 2020 through October 2021 to one of three internal medicine departments at the Laniado Hospital, a regional hospital with 400 beds in Israel. The main objective was to (a) identify the variables associated with the Norton Scale and (b) determine whether it predicts in-hospital mortality after adjustment for these variables.

Results

The Norton scale was associated with an older age, female gender, presence of a urinary catheter, and abnormal laboratory tests. The odds of in-hospital mortality in those with intermediate, high, and very high Norton scale risk groups were 3.10 (2.23–3.56), 6.48 (4.02–10.46), and 12.27 (7.37–20.44), respectively, after adjustment for the remaining predictors. Adding the Norton scale and the presence of a urinary catheter to the prediction logistic regression model that included age, gender, and abnormal laboratory test results increased the c-statistic from 0.870 (0.864–0.876) to 0.908 (0.902–0.913).

Conclusions

The Norton scale and presence of a urinary catheter are important predictors of in-hospital mortality in acutely hospitalized adults in internal medicine departments.

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Data availability

The data is available on a reasonable request.

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Author information

Authors and Affiliations

  1. The Adelson School Of Medicine, Ariel University, Ariel, Israel

    Zvi Shimoni

  2. Sanz Medical Center, Laniado Hospital, Netanya, 4244916, Israel

    Zvi Shimoni

  3. Computer Department, Laniado Hospital, Netanya, Israel

    Natan Dusseldorp & Izack Barnisan

  4. Nursing Department, Laniado Hospital, Netanya, Israel

    Yael Cohen

  5. Clinical Utility Department, Sanz Medical Center, Laniado Hospital, Netanya, 4244916, Israel

    Paul Froom

  6. School of Public Health, University of Tel Aviv, Tel Aviv, Israel

    Paul Froom

Authors
  1. Zvi Shimoni
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  2. Natan Dusseldorp
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  3. Yael Cohen
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  4. Izack Barnisan
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  5. Paul Froom
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Contributions

Study conception and design: ZS, ND, YC, IB, PF; data collection: ND, IB, PF; data analysis and interpretation: ZS, PF; drafting the article: ZS, PF; critical revision: ZS, ND, YC, IB PF.

Corresponding author

Correspondence to Paul Froom.

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The original online version of this article was revised: The above article was published with error in author name. The extension “MD” was included in in author’s family name. This is now corrected here.

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Shimoni, Z., Dusseldorp, N., Cohen, Y. et al. The Norton scale is an important predictor of in-hospital mortality in internal medicine patients. Ir J Med Sci 192, 1947–1952 (2023). https://doi.org/10.1007/s11845-022-03250-0

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  • DOI: https://doi.org/10.1007/s11845-022-03250-0

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