Contribution of individual items to the performance of the Norton pressure ulcer prediction scale.
OBJECTIVE
To assess the specific contribution to overall scale performance of each of the five items that constitute the Norton pressure ulcer prediction scale.


METHODS
A comparison of statistical models based on cross-sectional surveys of hospitalized patients.


METHODS
An urban teaching hospital in Geneva, Switzerland.


METHODS
2373 hospitalized patients who were free of pressure ulcers on admission.


METHODS
Norton scale items measuring activity, mobility, physical condition, mental condition, and incontinence on a 4-point scale were examined as predictors of stage 1 or greater pressure ulcers.


RESULTS
A total of 245 new pressure ulcers occurred between admission and patient observation. After adjustment for other independent predictors in proportional hazards models, only the activity and mobility items remained associated significantly with the risk of pressure ulcer. A simplified 2-item scale was more strongly associated with pressure ulcer risk than was the classic 5-item Norton scale.


CONCLUSIONS
Our study suggests that the activity and mobility items of the Norton scale are sufficient to express the risk of pressure ulcers in hospitalized patients. Confirmation of this finding in prospective studies is warranted.
Geneva University Hospitals, Institute of Social and Preventive Medicine, University of Geneva, Switzerland.
T V
TV
Perneger
J M
JM
Gaspoz
A C
AC
Raë
F
F
Borst
C
C
Héliot
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D006304:Health Status; D006760:Hospitalization; D006784:Hospitals, Teaching; D006801:Humans; D007103:Immobilization / Q000009:adverse effects; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011237:Predictive Value of Tests; D003668:Pressure Ulcer / Q000453:epidemiology* / Q000209:etiology; D012307:Risk Factors; D013557:Switzerland / Q000453:epidemiology; D014549:Urinary Incontinence / Q000150:complications