title: Low admission Norton scale scores are associated with falls long after rehabilitation in the elderly with hip fractures.
abstract: BACKGROUND
  In this study, we investigated if low admission Norton scale scores (ANSS) are associated with falls, fractures, hospitalizations, and death, after rehabilitation in the elderly with hip fractures.
  
  
  METHODS
  This prospective historical study followed consecutive elderly patients (≥65 years) who were admitted for rehabilitation following hip fracture surgery during 2009 and followed up in January or February 2012. The incidence of falls, number of falls, incidence of fractures, number of hospitalizations, and death rates were compared between patients with low (≤14) and high (≥15) ANSS.
  
  
  RESULTS
  The final cohort included 174 patients of mean age 83.6 ± 6.2 years, with 133 (76.4%) being women. Fifty-seven (27.0%) patients died during follow-up. Of the remaining 127 patients, 44 (34.6%) fell at least once and 15 (11.8%) suffered fractures. Overall, 81 (46.6%) patients had a low ANSS. Relative to patients with a high ANSS, they had a higher incidence of falls (odds ratio 3.3, 95% confidence interval 1.5-7.1; P = 0.002) and fell more times (1.2 ± 1.8 versus 0.6 ± 1.7; P = 0.002). Regression analysis showed that ANSS (as a parametric variable) as well as a low ANSS (as a nonparametric variable) were independently associated with falls (P = 0.002 and P = 0.009, respectively). There were no differences between patients with low and high ANSS in terms of incidence of fractures, number of hospitalizations, and death rates.
  
  
  CONCLUSIONS
  The Norton scoring system may be used for predicting falls long after rehabilitation in the elderly with hip fractures.
authors.affiliation: Department of Internal Medicine D, Sourasky Medical Center, Tel-Aviv, Israel.
authors.forename: Ehud
authors.initials: E
authors.lastname: Halperin
authors.forename: Tal
authors.initials: T
authors.lastname: Engel
authors.forename: Shany
authors.initials: S
authors.lastname: Sherman
authors.forename: Dan
authors.initials: D
authors.lastname: Justo
mesh_terms: D000058:Accidental Falls / Q000401:mortality / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D015577:Geriatric Assessment / Q000379:methods*; D006620:Hip Fractures / Q000534:rehabilitation*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D012737:Sex Factors
keywords: Norton scale; falls; hip fracture; rehabilitation