Age and Ageing, Vol 29, 63-68, Copyright © 2000 by British Geriatrics Society
RJ van Marum, ME Ooms, MW Ribbe and JT van Eijk
OBJECTIVE: To investigate the usefulness of a Dutch pressure sore risk
assessment scale--the Centraal Begeleidingsorgaan voor de Intercollegiale
Toetsing (CBO; National Organization for Quality Assurance in Hospitals)
score--in the detection of patients at risk of developing pressure sores
after admission to a nursing home. As the Norton score is the standard
method of risk assessment, we also investigated which score (Norton or CBO)
has the stronger relationship to the development of pressure sores. DESIGN:
Longitudinal cohort design. PATIENTS: 220 nursing home patients, 80 men,
140 women, mean age 79 years (standard deviation 3). MEASURES: Admission
assessments for the presence of pressure sores, CBO and Norton scores,
preventive measures and demographic characteristics. We made observations
every week for 4 weeks. MAIN OUTCOME MEASURE: Presence or absence of
pressure sores. MAIN RESULTS: 54 patients (25%) developed a pressure sore.
A significant, nonlinear relationship was found between the CBO score on
admission and the development of pressure ulcers for the first 2 weeks
after admission. Multiple logistic regression analysis showed that only
mobility (odds ratio = 3.6, P = 0.0001) and mental state (odds ratio = 2.0,
P = 0.03) showed a significant relationship with the development of
pressure ulcers. The CBO score was no better in risk assessment than the
Norton score. CONCLUSIONS: The CBO score can be used for assessment of the
risk of developing pressure ulcers in the first 2 weeks after admission to
a nursing home, but is no better than the Norton score. Since the Norton
score is easier to use, it is slightly preferable for use in this setting.
However, neither score is a good indicator of patients at risk. Physicians
should not depend solely on risk scores when prescribing preventive
measures.
ARTICLES
The Dutch pressure sore assessment score or the Norton scale for identifying at-risk nursing home patients?
Department of General Practice, Nursing Home Medicine and Social Medicine/Institute for Research in Extramural Medicine, Faculty of Medicine, Vrije Universiteit, Amsterdam, The Netherlands. rvmarum@knmg.nl
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