1
|
Ben Asher Kestin S, Israel A, Leshem E, Milman A, Sabbag A, Goldengerg I, Nof E, Beinart R. Can the Norton Scale Score Be Used as an Adjunct Tool for Implantable Defibrillator Patient Selection? A Retrospective Single-Center Cohort Study. J Clin Med 2022; 12:jcm12010214. [PMID: 36615015 PMCID: PMC9821316 DOI: 10.3390/jcm12010214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/16/2022] [Accepted: 12/20/2022] [Indexed: 12/29/2022] Open
Abstract
(1) Background: Implantable cardioverter defibrillators (ICDs) have become the standard of care in the prevention of sudden cardiac death, yet studies have shown that competing causes of death may limit ICD benefits. The Norton scale is a pressure ulcer risk score shown to have prognostic value in other fields. The purpose of this study was to assess the use of the Norton scale as an aid for ICD patient selection; (2) Methods: The study was comprised of consecutive patients who underwent defibrillator implantation at Sheba Medical Center between 2008 and 2016. A competing risk analysis was performed to assess the likelihood of death prior to device therapy; (3) Results: 695 patients were included. A total of 59 (8.5%) patients had low admission Norton scale score (ANSS) (≤14), 81 (11.7%) had intermediate ANSS (15−17), and the remainder (79.8%) had high (18−20) ANSS. The cumulative probability of all-cause mortality within one year of ICD implantation in patients with low ANSS was 30%, compared with 20% and 7% among the intermediate- and high-ANSS groups, respectively. Moreover, the one-year mortality rate without ICD therapy in low-ANSS patients was over four-fold compared with that of high-ANSS patients (33% versus 7%, p < 0.0001); (4) Conclusions: The Norton scale could be a useful additional tool in predicting the life expectancy of ICD candidates, thereby improving patient selection.
Collapse
Affiliation(s)
- Shir Ben Asher Kestin
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel
- Department of Internal Medicine C, Meir Medical Center, Kfar-Saba 4428164, Israel
- Correspondence: (S.B.A.K.); (R.B.)
| | - Ariel Israel
- Leumit Research Institute, Leumit Health Services, Tel-Aviv 647378, Israel
| | - Eran Leshem
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel
- Leviev Heart Center, Sheba Medical Center, Ramat Gan 5266202, Israel
| | - Anat Milman
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel
- Leviev Heart Center, Sheba Medical Center, Ramat Gan 5266202, Israel
| | - Avi Sabbag
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel
- Leviev Heart Center, Sheba Medical Center, Ramat Gan 5266202, Israel
| | - Ilan Goldengerg
- Department of Medicine, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Eyal Nof
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel
- Leviev Heart Center, Sheba Medical Center, Ramat Gan 5266202, Israel
| | - Roy Beinart
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel
- Leviev Heart Center, Sheba Medical Center, Ramat Gan 5266202, Israel
- Correspondence: (S.B.A.K.); (R.B.)
| |
Collapse
|
2
|
Harding I, Kaura A, Yue A, Roberts P, Murgatroyd F, Scott PA. Impact of different selection policies on subcutaneous ICD implants and therapies. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2020; 43:558-565. [DOI: 10.1111/pace.13936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 04/09/2020] [Accepted: 05/06/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Idris Harding
- Department of CardiologyKing's College Hospital London UK
| | - Amit Kaura
- Department of CardiologyImperial College London UK
| | - Arthur Yue
- Department of CardiologySouthampton General Hospital Southampton Hampshire UK
| | - Paul Roberts
- Department of CardiologySouthampton General Hospital Southampton Hampshire UK
| | | | - Paul A Scott
- Department of CardiologyKing's College Hospital London UK
| |
Collapse
|