Is Norton Score a useful tool for identifying high‐risk patients prior to emergency surgery?
Background Emergency surgery in elderly patients is associated with high mortality rates. Various scoring systems may be valuable in predicting mortality and morbidity rates. It has been suggested that the Norton Score (NS) could be used to quantify frailty. We hypothesized that NS could be a useful...
Gespeichert in:
| Veröffentlicht in: | ANZ journal of surgery 2019-04, Vol.89 (4), p.362-366 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 366 |
|---|---|
| container_issue | 4 |
| container_start_page | 362 |
| container_title | ANZ journal of surgery |
| container_volume | 89 |
| creator | Trostchansky, Ivan Nimrod, Adi Tiberiu, Ezri Vigorita, Vincenzo Valiñas, Roberto Karp, Galia |
| description | Background
Emergency surgery in elderly patients is associated with high mortality rates. Various scoring systems may be valuable in predicting mortality and morbidity rates. It has been suggested that the Norton Score (NS) could be used to quantify frailty. We hypothesized that NS could be a useful tool for identifying high‐risk patients before emergency/urgent surgeries.
Methods
A retrospective study was conducted in the Department of Surgery at Kaplan Medical Center, Rehovot, Israel. Inclusion criteria: age ≥50 years, American Society of Anesthesiologists (ASA) physical status score ≥3 and urgent/emergency laparotomy. A total of 400 patients were identified, and 150 (37.5%) matched the inclusion criteria.
Results
A total of 150 patients with ASA scores of 3–5 and who underwent emergent/urgent laparotomy from 1 January 2011 through 31 January 2013 were included. Mean age was 77 ± 9.7 years. The mortality rate at 1 month was 44% (66 patients) and at 1 year was 54.7% (82 patients). A higher ASA score was significantly associated with mortality (P < 0.001). Survivors had lower frailty scores and presented significantly higher preoperative NS (Modified Frailty Index 2.45 versus 3.06, P < 0.05; NS 16.09 versus 12.94, P < 0.01). Preoperative NS was the most significant variable that predicted poor patient prognosis (odds ratio 0.84; 95% confidence interval 0.73–0.96). For ASA 3 and ASA 4, the grade of daily personal independence in activities showed a positive correlation with survival (P < 0.001).
Conclusion
NS can be a very useful and quick tool to evaluate surgical risk in emergency surgery. Our study supports the use of NS in the perioperative evaluation prior to emergency surgery.
Emergency surgery in elderly patients is associated with high mortality rates. Various scoring systems may be valuable to predict mortality and morbidity rates. It has lately been suggested that the Norton Score could be used to indirectly quantify frailty. |
| doi_str_mv | 10.1111/ans.15107 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2193601872</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2202123150</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3537-3b3e723d7397b131962e8886dc850fd4490cb4e27405e9bcd43051db2acad5123</originalsourceid><addsrcrecordid>eNp1kMtKxDAUQIMoPkYX_oAE3OiiY559rGQQHwOii9GtoU1vx2inGZMW6c5P8Bv9EqMdXQhmkws5HHIPQvuUjGk4J3njx1RSkqyhbSqEjBjNkvXVTAXnW2jH-ydCaBxnchNtcZKmnBCxjR6mHt9Y19oGz7R1gHPceai6GrfW1riyDpsSmtZUvWnm-NHMHz_e3p3xz3iZtya8eLx0JmCtxbAAN4dG99h3YXD96S7aqPLaw97qHqH7i_O7s6vo-vZyeja5jjSXPIl4wSFhvEx4lhSU0yxmkKZpXOpUkqoUIiO6EMASQSRkhS4FJ5KWBct1XkrK-AgdDd6lsy8d-FYtjNdQ13kDtvMqBOExoWnyhR7-QZ9s55rwO8UYYUFGJQnU8UBpZ713UKmw5SJ3vaJEfUVXIbr6jh7Yg5WxKxZQ_pI_lQNwMgCvpob-f5Oa3MwG5Sc0AotL</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2202123150</pqid></control><display><type>article</type><title>Is Norton Score a useful tool for identifying high‐risk patients prior to emergency surgery?</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Trostchansky, Ivan ; Nimrod, Adi ; Tiberiu, Ezri ; Vigorita, Vincenzo ; Valiñas, Roberto ; Karp, Galia</creator><creatorcontrib>Trostchansky, Ivan ; Nimrod, Adi ; Tiberiu, Ezri ; Vigorita, Vincenzo ; Valiñas, Roberto ; Karp, Galia</creatorcontrib><description>Background
Emergency surgery in elderly patients is associated with high mortality rates. Various scoring systems may be valuable in predicting mortality and morbidity rates. It has been suggested that the Norton Score (NS) could be used to quantify frailty. We hypothesized that NS could be a useful tool for identifying high‐risk patients before emergency/urgent surgeries.
Methods
A retrospective study was conducted in the Department of Surgery at Kaplan Medical Center, Rehovot, Israel. Inclusion criteria: age ≥50 years, American Society of Anesthesiologists (ASA) physical status score ≥3 and urgent/emergency laparotomy. A total of 400 patients were identified, and 150 (37.5%) matched the inclusion criteria.
Results
A total of 150 patients with ASA scores of 3–5 and who underwent emergent/urgent laparotomy from 1 January 2011 through 31 January 2013 were included. Mean age was 77 ± 9.7 years. The mortality rate at 1 month was 44% (66 patients) and at 1 year was 54.7% (82 patients). A higher ASA score was significantly associated with mortality (P < 0.001). Survivors had lower frailty scores and presented significantly higher preoperative NS (Modified Frailty Index 2.45 versus 3.06, P < 0.05; NS 16.09 versus 12.94, P < 0.01). Preoperative NS was the most significant variable that predicted poor patient prognosis (odds ratio 0.84; 95% confidence interval 0.73–0.96). For ASA 3 and ASA 4, the grade of daily personal independence in activities showed a positive correlation with survival (P < 0.001).
Conclusion
NS can be a very useful and quick tool to evaluate surgical risk in emergency surgery. Our study supports the use of NS in the perioperative evaluation prior to emergency surgery.
Emergency surgery in elderly patients is associated with high mortality rates. Various scoring systems may be valuable to predict mortality and morbidity rates. It has lately been suggested that the Norton Score could be used to indirectly quantify frailty.</description><identifier>ISSN: 1445-1433</identifier><identifier>EISSN: 1445-2197</identifier><identifier>DOI: 10.1111/ans.15107</identifier><identifier>PMID: 30883004</identifier><language>eng</language><publisher>Melbourne: John Wiley & Sons Australia, Ltd</publisher><subject>Aged ; Aged, 80 and over ; Case-Control Studies ; Confidence intervals ; elderly ; Emergencies ; emergency ; Emergency Treatment - mortality ; Emergency Treatment - standards ; Female ; Frailty ; Frailty - mortality ; General Surgery - methods ; General Surgery - trends ; Geriatrics ; Health care facilities ; Humans ; Identification methods ; Israel - epidemiology ; Laparotomy - methods ; Male ; Medical prognosis ; Morbidity ; Mortality ; Norton ; Older people ; Patients ; Postoperative Complications - mortality ; Preoperative Period ; Prognosis ; Research Design - standards ; Retrospective Studies ; Risk ; Risk Assessment ; Risk Factors ; Surgery ; Surgical instruments</subject><ispartof>ANZ journal of surgery, 2019-04, Vol.89 (4), p.362-366</ispartof><rights>2019 Royal Australasian College of Surgeons</rights><rights>2019 Royal Australasian College of Surgeons.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3537-3b3e723d7397b131962e8886dc850fd4490cb4e27405e9bcd43051db2acad5123</citedby><cites>FETCH-LOGICAL-c3537-3b3e723d7397b131962e8886dc850fd4490cb4e27405e9bcd43051db2acad5123</cites><orcidid>0000-0002-9023-3750 ; 0000-0003-2142-4737</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fans.15107$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fans.15107$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30883004$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Trostchansky, Ivan</creatorcontrib><creatorcontrib>Nimrod, Adi</creatorcontrib><creatorcontrib>Tiberiu, Ezri</creatorcontrib><creatorcontrib>Vigorita, Vincenzo</creatorcontrib><creatorcontrib>Valiñas, Roberto</creatorcontrib><creatorcontrib>Karp, Galia</creatorcontrib><title>Is Norton Score a useful tool for identifying high‐risk patients prior to emergency surgery?</title><title>ANZ journal of surgery</title><addtitle>ANZ J Surg</addtitle><description>Background
Emergency surgery in elderly patients is associated with high mortality rates. Various scoring systems may be valuable in predicting mortality and morbidity rates. It has been suggested that the Norton Score (NS) could be used to quantify frailty. We hypothesized that NS could be a useful tool for identifying high‐risk patients before emergency/urgent surgeries.
Methods
A retrospective study was conducted in the Department of Surgery at Kaplan Medical Center, Rehovot, Israel. Inclusion criteria: age ≥50 years, American Society of Anesthesiologists (ASA) physical status score ≥3 and urgent/emergency laparotomy. A total of 400 patients were identified, and 150 (37.5%) matched the inclusion criteria.
Results
A total of 150 patients with ASA scores of 3–5 and who underwent emergent/urgent laparotomy from 1 January 2011 through 31 January 2013 were included. Mean age was 77 ± 9.7 years. The mortality rate at 1 month was 44% (66 patients) and at 1 year was 54.7% (82 patients). A higher ASA score was significantly associated with mortality (P < 0.001). Survivors had lower frailty scores and presented significantly higher preoperative NS (Modified Frailty Index 2.45 versus 3.06, P < 0.05; NS 16.09 versus 12.94, P < 0.01). Preoperative NS was the most significant variable that predicted poor patient prognosis (odds ratio 0.84; 95% confidence interval 0.73–0.96). For ASA 3 and ASA 4, the grade of daily personal independence in activities showed a positive correlation with survival (P < 0.001).
Conclusion
NS can be a very useful and quick tool to evaluate surgical risk in emergency surgery. Our study supports the use of NS in the perioperative evaluation prior to emergency surgery.
Emergency surgery in elderly patients is associated with high mortality rates. Various scoring systems may be valuable to predict mortality and morbidity rates. It has lately been suggested that the Norton Score could be used to indirectly quantify frailty.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Case-Control Studies</subject><subject>Confidence intervals</subject><subject>elderly</subject><subject>Emergencies</subject><subject>emergency</subject><subject>Emergency Treatment - mortality</subject><subject>Emergency Treatment - standards</subject><subject>Female</subject><subject>Frailty</subject><subject>Frailty - mortality</subject><subject>General Surgery - methods</subject><subject>General Surgery - trends</subject><subject>Geriatrics</subject><subject>Health care facilities</subject><subject>Humans</subject><subject>Identification methods</subject><subject>Israel - epidemiology</subject><subject>Laparotomy - methods</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Morbidity</subject><subject>Mortality</subject><subject>Norton</subject><subject>Older people</subject><subject>Patients</subject><subject>Postoperative Complications - mortality</subject><subject>Preoperative Period</subject><subject>Prognosis</subject><subject>Research Design - standards</subject><subject>Retrospective Studies</subject><subject>Risk</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Surgery</subject><subject>Surgical instruments</subject><issn>1445-1433</issn><issn>1445-2197</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kMtKxDAUQIMoPkYX_oAE3OiiY559rGQQHwOii9GtoU1vx2inGZMW6c5P8Bv9EqMdXQhmkws5HHIPQvuUjGk4J3njx1RSkqyhbSqEjBjNkvXVTAXnW2jH-ydCaBxnchNtcZKmnBCxjR6mHt9Y19oGz7R1gHPceai6GrfW1riyDpsSmtZUvWnm-NHMHz_e3p3xz3iZtya8eLx0JmCtxbAAN4dG99h3YXD96S7aqPLaw97qHqH7i_O7s6vo-vZyeja5jjSXPIl4wSFhvEx4lhSU0yxmkKZpXOpUkqoUIiO6EMASQSRkhS4FJ5KWBct1XkrK-AgdDd6lsy8d-FYtjNdQ13kDtvMqBOExoWnyhR7-QZ9s55rwO8UYYUFGJQnU8UBpZ713UKmw5SJ3vaJEfUVXIbr6jh7Yg5WxKxZQ_pI_lQNwMgCvpob-f5Oa3MwG5Sc0AotL</recordid><startdate>201904</startdate><enddate>201904</enddate><creator>Trostchansky, Ivan</creator><creator>Nimrod, Adi</creator><creator>Tiberiu, Ezri</creator><creator>Vigorita, Vincenzo</creator><creator>Valiñas, Roberto</creator><creator>Karp, Galia</creator><general>John Wiley & Sons Australia, Ltd</general><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-9023-3750</orcidid><orcidid>https://orcid.org/0000-0003-2142-4737</orcidid></search><sort><creationdate>201904</creationdate><title>Is Norton Score a useful tool for identifying high‐risk patients prior to emergency surgery?</title><author>Trostchansky, Ivan ; Nimrod, Adi ; Tiberiu, Ezri ; Vigorita, Vincenzo ; Valiñas, Roberto ; Karp, Galia</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3537-3b3e723d7397b131962e8886dc850fd4490cb4e27405e9bcd43051db2acad5123</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Case-Control Studies</topic><topic>Confidence intervals</topic><topic>elderly</topic><topic>Emergencies</topic><topic>emergency</topic><topic>Emergency Treatment - mortality</topic><topic>Emergency Treatment - standards</topic><topic>Female</topic><topic>Frailty</topic><topic>Frailty - mortality</topic><topic>General Surgery - methods</topic><topic>General Surgery - trends</topic><topic>Geriatrics</topic><topic>Health care facilities</topic><topic>Humans</topic><topic>Identification methods</topic><topic>Israel - epidemiology</topic><topic>Laparotomy - methods</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Morbidity</topic><topic>Mortality</topic><topic>Norton</topic><topic>Older people</topic><topic>Patients</topic><topic>Postoperative Complications - mortality</topic><topic>Preoperative Period</topic><topic>Prognosis</topic><topic>Research Design - standards</topic><topic>Retrospective Studies</topic><topic>Risk</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Surgery</topic><topic>Surgical instruments</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Trostchansky, Ivan</creatorcontrib><creatorcontrib>Nimrod, Adi</creatorcontrib><creatorcontrib>Tiberiu, Ezri</creatorcontrib><creatorcontrib>Vigorita, Vincenzo</creatorcontrib><creatorcontrib>Valiñas, Roberto</creatorcontrib><creatorcontrib>Karp, Galia</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>ANZ journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Trostchansky, Ivan</au><au>Nimrod, Adi</au><au>Tiberiu, Ezri</au><au>Vigorita, Vincenzo</au><au>Valiñas, Roberto</au><au>Karp, Galia</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Is Norton Score a useful tool for identifying high‐risk patients prior to emergency surgery?</atitle><jtitle>ANZ journal of surgery</jtitle><addtitle>ANZ J Surg</addtitle><date>2019-04</date><risdate>2019</risdate><volume>89</volume><issue>4</issue><spage>362</spage><epage>366</epage><pages>362-366</pages><issn>1445-1433</issn><eissn>1445-2197</eissn><abstract>Background
Emergency surgery in elderly patients is associated with high mortality rates. Various scoring systems may be valuable in predicting mortality and morbidity rates. It has been suggested that the Norton Score (NS) could be used to quantify frailty. We hypothesized that NS could be a useful tool for identifying high‐risk patients before emergency/urgent surgeries.
Methods
A retrospective study was conducted in the Department of Surgery at Kaplan Medical Center, Rehovot, Israel. Inclusion criteria: age ≥50 years, American Society of Anesthesiologists (ASA) physical status score ≥3 and urgent/emergency laparotomy. A total of 400 patients were identified, and 150 (37.5%) matched the inclusion criteria.
Results
A total of 150 patients with ASA scores of 3–5 and who underwent emergent/urgent laparotomy from 1 January 2011 through 31 January 2013 were included. Mean age was 77 ± 9.7 years. The mortality rate at 1 month was 44% (66 patients) and at 1 year was 54.7% (82 patients). A higher ASA score was significantly associated with mortality (P < 0.001). Survivors had lower frailty scores and presented significantly higher preoperative NS (Modified Frailty Index 2.45 versus 3.06, P < 0.05; NS 16.09 versus 12.94, P < 0.01). Preoperative NS was the most significant variable that predicted poor patient prognosis (odds ratio 0.84; 95% confidence interval 0.73–0.96). For ASA 3 and ASA 4, the grade of daily personal independence in activities showed a positive correlation with survival (P < 0.001).
Conclusion
NS can be a very useful and quick tool to evaluate surgical risk in emergency surgery. Our study supports the use of NS in the perioperative evaluation prior to emergency surgery.
Emergency surgery in elderly patients is associated with high mortality rates. Various scoring systems may be valuable to predict mortality and morbidity rates. It has lately been suggested that the Norton Score could be used to indirectly quantify frailty.</abstract><cop>Melbourne</cop><pub>John Wiley & Sons Australia, Ltd</pub><pmid>30883004</pmid><doi>10.1111/ans.15107</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0002-9023-3750</orcidid><orcidid>https://orcid.org/0000-0003-2142-4737</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1445-1433 |
| ispartof | ANZ journal of surgery, 2019-04, Vol.89 (4), p.362-366 |
| issn | 1445-1433 1445-2197 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2193601872 |
| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Aged Aged, 80 and over Case-Control Studies Confidence intervals elderly Emergencies emergency Emergency Treatment - mortality Emergency Treatment - standards Female Frailty Frailty - mortality General Surgery - methods General Surgery - trends Geriatrics Health care facilities Humans Identification methods Israel - epidemiology Laparotomy - methods Male Medical prognosis Morbidity Mortality Norton Older people Patients Postoperative Complications - mortality Preoperative Period Prognosis Research Design - standards Retrospective Studies Risk Risk Assessment Risk Factors Surgery Surgical instruments |
| title | Is Norton Score a useful tool for identifying high‐risk patients prior to emergency surgery? |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-01T03%3A43%3A29IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Is%20Norton%20Score%20a%20useful%20tool%20for%20identifying%20high%E2%80%90risk%20patients%20prior%20to%20emergency%20surgery?&rft.jtitle=ANZ%20journal%20of%20surgery&rft.au=Trostchansky,%20Ivan&rft.date=2019-04&rft.volume=89&rft.issue=4&rft.spage=362&rft.epage=366&rft.pages=362-366&rft.issn=1445-1433&rft.eissn=1445-2197&rft_id=info:doi/10.1111/ans.15107&rft_dat=%3Cproquest_cross%3E2202123150%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2202123150&rft_id=info:pmid/30883004&rfr_iscdi=true |