Norton scale scores and 1-year mortality in elderly patients following lower limb amputations

Background: The Norton scale is used for assessing the risk of pressure ulcers. The association between low admission Norton scale scores (ANSS), complications and mortality in elderly patients following lower limb amputations has never been studied until now. Objectives: The aim of this study was to investigate if low ANSSs are associated with complications the 30-day and 1-year mortality in elderly patients following lower limb amputations. Materials and methods: The medical charts of 104 elderly (≥ 65 years) patients following lower limb amputations were studied for the following measurements: ANSS, demographics, comorbidities, complications during hospitalization, 30-day mortality and 1-year mortality. Complications included acute coronary syndrome, major bleeding, stroke, systemic infections, organ failure and thromboembolism. An ANSS ≤ 14 was considered as being low. Results: Overall 54 (51.9 %) patients underwent below-knee amputations and 50 (48.1 %) patients underwent above-knee amputations. Most (n = 78; 75.0 %) patients were men and the mean age was 78.5 ± 7.9 years. Following the amputation 46 (44.2 %) patients had complications other than pressure ulcers, 24 (23.1 %) patients died within 30 days and 63 (60.6 %) patients died within 1 year. A total of 61 (58.7 %) patients had a low ANSS. The incidence of complications other than pressure ulcers, 30-day and 1-year mortality rates were higher in patients with a low ANSS relative to patients with a high ANSS. A regression analysis showed that 1-year mortality was independently negatively associated with ANSS (t = −2.629; p = 0.010). Conclusion: The Norton scale can be used for predicting 1-year mortality in elderly patients following lower limb amputations.