title: Admission Norton scale scores (ANSS) are associated with post-operative complications following spine fracture surgery in the elderly.
abstract: We sought to determine if low ANSS, usually associated with high pressure ulcer risk, are also associated with post-operative complications following spine fracture surgery in the elderly. This was a retrospective cross-sectional study conducted at the division of orthopedic surgery in a tertiary medical center between January 2008 and October 2010. The medical charts of consecutive elderly (≥ 65 years) patients admitted for spine fracture surgery were studied for the following measurements: ANSS, demographic data, co-morbidities, and post-operative complications. Except for pressure ulcers, post-operative complications included: acute coronary syndrome, acute renal failure, confusion, pneumonia, urinary tract infection, venous thromboembolism, and wound infection. The final cohort included 90 patients: 66 (73.3%) females and 24 (26.7%) males. Mean age for the entire cohort was 78.9 ± 0.7 years. Most patients had lumbar fractures (n=49; 54.4%) or thoracal fractures (n=26; 28.9%). Most patients underwent kyphoplasty (n=65; 72.2%). Mean ANSS was 15.9 ± 0.3, and 29 (32.2%) patients had low (<15) ANSS. Patients with low ANSS had significantly more post-operative complications relative to patients with high ANSS (1.0 ± 0.2 vs. 0.2 ± 0.1; p<0.0001). Among all post-operative complications, urinary tract infection was independently associated with ANSS (p<0.0001). Binary regression analysis showed that ANSS were independently associated with post-operative complications (p=0.001). We conclude that low ANSS are associated with post-operative complications and urinary tract infection in particular, following spine fracture surgery in the elderly. Hence, the Norton scoring system may be used for predicting and preventing post-operative complications in this population.
authors: Division of Orthopedic Surgery, Sourasky Medical Center, 6 Weitzman Street, Tel-Aviv 64239, Israel.
authors: Ronen
authors: R
authors: Sever
authors: Aviram
authors: A
authors: Gold
authors: Ortal
authors: O
authors: Segal
authors: Gilad
authors: G
authors: Regev
authors: Ory
authors: O
authors: Keynan
authors: Moshe
authors: M
authors: Salai
authors: Dan
authors: D
authors: Justo
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology / Q000209:etiology; D058186:Acute Kidney Injury / Q000453:epidemiology / Q000209:etiology; D000368:Aged; D000369:Aged, 80 and over; D003221:Confusion / Q000453:epidemiology / Q000209:etiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D058498:Kyphoplasty; D008297:Male; D019637:Orthopedic Procedures / Q000009:adverse effects* / Q000706:statistics & numerical data; D010343:Patient Admission; D011014:Pneumonia / Q000453:epidemiology / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016103:Spinal Fractures / Q000453:epidemiology / Q000601:surgery*; D016896:Treatment Outcome; D014552:Urinary Tract Infections / Q000453:epidemiology / Q000209:etiology; D054556:Venous Thromboembolism / Q000453:epidemiology / Q000209:etiology; D014946:Wound Infection / Q000453:epidemiology / Q000209:etiology