诺顿量表评估老年患者脊柱骨折术后并发症风险  

Evaluating the risk of post-operative complications following spine fracture surgery in the elderly by Norton scale scores

作　　者：苏燕 第荣静 Su Yan;Di Rong-jing(Department of Orthopedics,Tongji hospital,Tongji University School of Medicine,Shanghai 200000,Chin)

机构地区：[1]上海市同济大学医学院/上海市同济医院骨科,上海200000

出　　处：《实用临床护理学电子杂志》2018年第26期3-4,7,共3页Electronic Journal of Practical Clinical Nursing Science

摘　　要：目的探讨诺顿量表(Norton)是否可用于老年脊柱骨折手术患者术后并发症风险评估。方法收集2012年1月至2014年1月在我院接受脊柱骨折手术的老年患者(年龄≥65岁)的资料,回顾性分析患者入院当日诺顿量表评分(Norton scale scores,ANSS)与人口学资料、术前合并症和术后并发症的关系。结果收集患者83例,年龄78.07±0.89岁,女性53例(63.9%)。腰椎骨折和胸椎骨折分别为46例(55.5%)和24例(28.9%)。其中,19例(22.89%)患者累计发生了33次压疮以外的术后并发症(急性冠脉综合征、肺炎、尿路感染和伤口感染)。入院当日ANSS评分中位数为17(四分位数,14-19),低ANSS组(<15分)为28例(33.73%)。低ANSS组患者发生术后并发症(压疮除外)的次数显著高于高ANSS组[1.0(IQR,0-2)vs 0(IQR,0-0),p=0.0017]。在术后并发症(压疮除外)中,尿路感染和ANSS有相关性(p<0.0001)。二元回归分析显示,入院当日ANSS是老年脊柱骨折患者术后发生并发症的独立危险因素(p<0.0001)。结论诺顿量表可能"老表新用",用于老年脊柱骨折术后并发症的风险评估。Objective To investigate if the admission Norton scale scores （ANSS）is applicable to evacuate the risk ofpost-operative complications following spine fracture surgery in the elderly. Methods This was a retrospective cross-sectionalstudy which carried out at the division of orthopedic surgery in our Hospital between January 2012 and January 2014. Themedical charts of consecutive elderly （≥65 years）patients admitted for spine fracture surgery were analyzed for the followingmeasurements ANSS,demographic data, co-morbidities, and post-operative complications. Results 83 patients were enrolledin the final study, with 53（63.9%） females and 30 （36.1%） males. Mean age for the total cohort was 78.07±0.89 years.Mostpatients suffered from lumbar fractures （n = 46; 55.5%） or thoracal fractures （n = 24; 28.9%）. 33 post-operation complicationsother than pressure ulcer , such as acute coronary syndrome, pneumonia,urinary tract infection and wound infection, wereobserved in 19 （22.89%）of the entire cohort. The median of admission ANSS was 17（IQR,14-19） for the overall cohort and28 （33.73%） of them had low （〈15）ANSS. Patients of low ANSS had significantly more post-operative complications incomparison with patients of high ANSS [1.0 （IQR,0-2）vs 0 （IQR,0-0）,p =0.0017]. Among all post-operative complications,urinary tract infection was independently associated with ANSS （p 〈 0.0001）. Binary regression analysis found that ANSS wereindependently associated with post-operative complications （p 〈0.0001）. Conclusion Based on the findings of the present studythat low ANSS are associated with post-operative complications,the Norton scoring system may be used for predicting postoperativecomplications in elderly patients following spine fracture surgery.

关 键 词：脊柱骨折 诺顿评分 术后并发症 压疮 

分 类 号：R473[医药卫生—护理学]