The relationship between inflammatory markers and mortality in patients undergoing proximal femoral nail fixation for intertrochanteric femur fractures

Yıl 2024, Cilt: 29 Sayı: 1, 76 - 82, 27.01.2024

Murat Danışman Azime Bulut

https://doi.org/10.21673/anadoluklin.1363996

Öz

Aim: This study aimed to investigate the predictability of mortality based on biomarkers measured using complete blood count in geriatric patients who underwent proximal femoral nail fixation for intertrochanteric femur fractures.

Methods: We included in this retrospective study 247 patients who had undergone proximal femoral nailing due to osteoporotic intertrochanteric femur fracture. The patients were divided into two groups according to 1-year mortality outcome: group A, survivors (n=162), and group B, deceased patients (n=85). Preoperative demographic information, the number of days until surgery, C-reactive protein (CRP) level, hemoglobin level, platelet-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and systemic immune-inflammatory index (SII) were recorded.

Results: No statistically significant differences were found between the groups in terms of sex, type of anesthesia, leukocyte count, and neutrophil level (p>0.05), but statistically significant differences were found in age, number of days until surgery, CRP level, hemoglobin level, lymphocyte count, and platelet count (p<0.05). The NLR significantly increased in the group with mortality (p<0.05), while SII and PLR yielded similar results in both groups (p>0.05). In the receiver-operating characteristic curve analysis, the NLR, SII, and PLR areas under the curve for mortality were 0.598, 0.549, and 0.569, respectively.

Conclusion: None of the biomarkers investigated in this study showed an ability to distinguish patients with higher mortality risks. Therefore, these biomarkers may be recommended not as predictive of mortality but as supportive parameters for determining patients’ overall clinical statuses.

Anahtar Kelimeler

Biomarkers, inflammation, intertrochanteric fractures, mortality determinants

İntertrokanterik kırık nedeniyle proksimal femur çivisi uygulanan hastalarda inflamatuar indekslerle mortalitenin ilişkisi

Öz

Amaç: Bu çalışmanın amacı, intertrokanterik femur kırıkları sonrası proksimal femoral çivileme uygulanan geriatrik hastalarda tam kan sayımındaki biyobelirteçlerle mortalite öngörülebilirliğini araştırmaktır.

Yöntem: Osteoporotik intertrokanterik femur kırığı nedeniyle proksimal femoral çivileme uygulanan 247 hasta çalışmamıza dahil edildi. Hastalar iki gruba ayrıldı. Grup A, ameliyat sonrası birinci yılı sağ kalan hastaları (n=162), Grup B ise aynı dönemde ölen hastaları içeriyordu (n=85). Preoperatif demografik bilgiler, ameliyata kadar geçen gün sayısı, C-reaktif protein (CRP), hemoglobin, platelet-lenfosit oranı (PLR), nötrofil-lenfosit oranı (NLR) ve sistemik immün-inflamatuar indeks (SII) incelendi.

Bulgular: Cinsiyet, anestezi türü, lökosit ve nötrofil seviyeleri açısından gruplar arasında istatistiksel olarak anlamlı bir fark bulunmamakla birlikte (p>0.05), yaş, ameliyata kadar geçen gün sayısı, CRP, hemoglobin, lenfosit ve trombosit seviyeleri açısından gruplar arası anlamlı fark bulunmuştur (p<0.05). NLR seviyesi, mortalite gösteren Grup B’de anlamlı olarak yüksek iken (p<0.05), SII ve PLR her iki grupta benzer sonuçlar verdi (p>0.05). ROC analizinde, mortalite için NLR, SII ve PLR için eğri altında kalan alan değerleri sırasıyla 0.598, 0.549 ve 0.569 idi.

Sonuçlar: Bu çalışmada, mortalite riski yüksek olan hastaları ayırt etme imkânı veren bir biyobelirteç bulunamamıştır. Bu nedenle, bu biyobelirteçlerin mortalite öngörülebilirliği için değil de, hastanın genel klinik durumu içinde destekleyici parametreler olarak kullanılabileceği önerilmelidir.

Anahtar Kelimeler

Biyobelirteçler, inflamasyon, intertrokanterik kırıklar, ölüm oranı belirleyicileri

Kaynakça

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