• Zvi Shimoni, Natan Dusseldorp, Yael Cohen, Izack Barnisan, and Paul Froom.
• The Adelson School Of Medicine, Ariel University, Ariel, Israel.
• Ir J Med Sci. 2023 Aug 1; 192 (4): 194719521947-1952.

BackgroundThe Norton scale, a marker of patient frailty used to predict the risk of pressure ulcers, but the predictive value of the Norton scale for in-hospital mortality after adjustment for a wide range of demographic, and abnormal admission laboratory test results shown in themselves to have a high predictive value for in-hospital mortality is unclear.AimThe study aims to determine the value of the Norton scale and the presence of a urinary catheter in predicting in hospital mortality.MethodsThe study population included all acutely admitted adult patients in 2020 through October 2021 to one of three internal medicine departments at the Laniado Hospital, a regional hospital with 400 beds in Israel. The main objective was to (a) identify the variables associated with the Norton Scale and (b) determine whether it predicts in-hospital mortality after adjustment for these variables.ResultsThe Norton scale was associated with an older age, female gender, presence of a urinary catheter, and abnormal laboratory tests. The odds of in-hospital mortality in those with intermediate, high, and very high Norton scale risk groups were 3.10 (2.23-3.56), 6.48 (4.02-10.46), and 12.27 (7.37-20.44), respectively, after adjustment for the remaining predictors. Adding the Norton scale and the presence of a urinary catheter to the prediction logistic regression model that included age, gender, and abnormal laboratory test results increased the c-statistic from 0.870 (0.864-0.876) to 0.908 (0.902-0.913).ConclusionsThe Norton scale and presence of a urinary catheter are important predictors of in-hospital mortality in acutely hospitalized adults in internal medicine departments.© 2022. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.

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