[Norton's decubitus risk score in a nursing home]

Decubitus must be considered an important problem in public health care. In the Netherlands (total population 15 million) the costs of prevention and treatment of decubitus in the hospitals and nursing homes are approximately Dfl. 700 million per year. In order to identify patients at risk for the development of decubitus at an early stage. Norton and colleagues developed a scoring system that includes an assessment of general physical condition, mental status, activity level, mobility and incontinence. In a prospective study in 224 somatic nursing home patients we investigated the relationship between the Norton-score and the appearance of decubitus. The authors conclude that, when using the Norton-score, it is not possible to differentiate patients at risk clearly from patients with no risk. From the five items used by Norton, only mobility and, to a lesser degree, general physical condition, show a significant relation with the occurrence of decubitus ulcers. In order to identify the patients at risk roughly, the physician can suffice with scoring these two items.