Kalça Kırığı Cerrahisi Geçiren Yaşlı Hastalarda İnflamasyon Belirteçlerinin Değerlendirilmesi

Yıl 2024, Cilt: 9 Sayı: 1, 61 - 65, 11.03.2024

Fatih Şahin Muhammed Halit Tekeci Havva Kocayigit Onur Palabıyık Alauddin Kochai

https://doi.org/10.26453/otjhs.1401020

Öz

Amaç: İleri yaş ortopedik hastalarda yüksek inflamatuar belirteçlerin kötü postoperatif sonuçların değerlendirilmesinde önemli olduğu düşünülmektedir. Amacımız 80 yaş üstü kalça kırığı ameliyatı geçirmiş hastalarda 30 günlük mortalite ve ameliyat öncesi değerlendirme açısından inflamatuar belirteçlerin etkisini araştırmaktır.
Materyal ve Metot: Kalça kırığı ameliyatı geçiren 80 yaş üstü hastalar çalışmaya dahil edildi. Yaş, cinsiyet, anestezi türü, komorbiditeler, antikoagülan kullanımı, yoğun bakım ünitesinde (YBÜ) yatış süresi, hastane yatış süresi, 30 günlük mortalite oranları kaydedilerek trombosit/lenfosit oranı (PLR), nötrofil/lenfosit oranı (NLR) ve sistemik immun inflamasyon indeksi (SII) değerleri hesaplandı.
Bulgular: Yaş ortalaması 85,48 ± 4,07 idi. Postoperatif YBÜ yatışı % 41,1 idi ve 30 günlük mortalite oranı ise %3,3 idi. PLR değeri 191 ± 105, NLR değeri 6,4 ± 4,5, SII değeri ise 1410 ± 1210 olarak saptandı. YBÜ yatışı ile mortalite, preoperatif ve postoperatif yatış süreleri arasında anlamlı korelasyon saptandı.
Sonuç: Yoğun bakıma yatış ile mortalite arasında pozitif bir ilişki bulunurken, PLR, NLR ve SII değerleri ile mortalite oranları arasında istatistiksel olarak anlamlı bir ilişki bulunmamasına rağmen literatürde belirtilen değerlere yakın yüksek değerler bulunmuştur.

Anahtar Kelimeler

Anestezi, inflamasyon belirteci, kalça kırığı, mortalite, yoğun bakım yatışı

Evaluation of Inflammation Markers in Elderly Patients Undergoing Hip Fracture Surgery

Öz

Objectives: High inflammatory markers are thought to be important in evaluating poor postoperative outcomes in older orthopedic patients. We aim to investigate the effect of inflammatory markers in patients over 80 who have undergone a hip fracture surgery regarding 30-day mortality and preoperative evaluation.
Materials and Methods: Patients over 80 who had undergone hip fracture surgery were included. Age, gender, type of anesthesia, comorbidities, anticoagulant, intensive care unit (ICU) admission, hospitalization period, 30-day mortality rates, were recorded and platelet/lymphocyte ratio (PLR), neutrophil/lymphocyte ratio (NLR) and systemic immune inflammation index (SII) values were calculated.
Results: The mean age was 85.48±4.07 years old. Postoperative ICU admission was found to be 41.1%, and the 30-day mortality rate was 3.3%. The PLR value was 191±105, the NLR value was 6.4±4.5, and the SII value was 1410±1210. A significant correlation was found between ICU hospitalization and mortality, preoperative and postoperative hospital stay.
Conclusion: While there was a positive correlation between intensive care hospitalization and mortality, although no statistically significant correlation was found between the PLR, NLR and SII values and mortality rates, high values close to those stated in the literature were found.

Anahtar Kelimeler

Anesthesia, hip fracture, inflammation marker, intensive care unit admission, mortality

Etik Beyan

Our study was approved by the Sakarya University Ethics Committee (Date: 02/02/22, Decision No: E-71522473-0.50.01.04-102134-26). The study was carried out following the international declaration and guidelines

Destekleyen Kurum

None

Teşekkür

None

Kaynakça

• 1. Katsoulis M, Benetou V, Karapetyan T, et al. Excess mortality after hip fracture in elderly persons from Europe and the USA: The CHANCES project. J Intern Med. 2017;281:300-310. doi:10.1111/joim.12586
• 2. Ensrud KE. Epidemiology of fracture risk with advancing age. J Gerontol A Biol Sci Med Sci. 2013;68:1236-1242. doi:10.1093/gerona/glt092
• 3. Chen, X, Zhang, J, Lin Y, Liu Z, Sun T, Wang X. Risk factors for postoperative mortality at 30 days in elderly Chinese patients with hip fractures. Osteoporos Int. 2022;33:1109-1116. doi:10.1007/s00198-021-06257-y
• 4. Abrahamsen B, van Staa T, Ariely R, Olson M, Cooper C. Excess mortality following hip fracture: A systematic epidemiological review. Osteoporosis International. 2009;20:1633-1650. doi:10.1007/s00198-009-0920-3
• 5. Norring-Agerskov D, Bathum L, Pedersen OB, et al. Biochemical markers of inflammation are associated with increased mortality in hip fracture patients: The Bispebjerg Hip Fracture Biobank. Aging Clin Exp Res. 2019;31:1727-1734. doi:10.1007/ s40520-019-01140-7
• 6. Thachil J. Platelets in inflammatory disorders: A pathophysiological and clinical perspective. Semin Thromb Hemost. 2015;41:572-581. doi:10.1055/s-0035-1556589
• 7. Palabiyik O, Bayar F, Caglar T, Toptas Y, Erdem AF, Tas Tuna A. Anesthetic techniques in octogenarians and older undergoing orthopedic surgery. J Clin Exp Invest. 2017;8(3):85-89.
• 8. Gasparyan AY, Ayvazyan L, Mukanova U, Yessirkepov M, Kitas GD. The platelet-to-lymphocyte ratio as an inflammatory marker in rheumatic diseases. Ann Lab Med. 2019;39(4):345-357. doi:10.3343/alm.2019.39.4.345
• 9. Fisher A, Srikusalanukul W, Fisher L, Smith P. The Neutrophil to Lymphocyte Ratio on Admission and Short-Term Outcomes in Orthogeriatric Patients. Int J Med Sci. 2016;13:588-602. doi:10.7150/ijms.15445
• 10. Gu L, Li H, Gao Y, et al. The association of platelet count with clinicopathological significance and prognosis in renal cell carcinoma: A systematic review and meta-analysis. PLoS One. 2015;10:e0125538. doi:10.1371/journal.pone.0125538
• 11. Lolli C, Basso U, Derosa L, et al. Systemic immune-inflammation index predicts the clinical outcome in patients with metastatic renal cell cancer treated with sunitinib. Oncotarget. 2016;7:54564-71. doi:10.18632/oncotarget.10515
• 12. Yang YL, Wu CH, Hsu PF, et al. Systemic immune-inflammation index (SII) predicted clinical outcome in patients with coronary artery disease. Eur J Clin Invest. 2020;50:e13230. doi:10.1111/eci.13230
• 13. Fang H, Zhang H, Wang Z, Zhou Z, Li Y, Lu L. Systemic immuneinflammation index acts as a novel diagnostic biomarker for postmenopausal osteoporosis and could predict the risk of osteoporotic fracture. J Clin Lab Anal. 2020;34(1):e23016. doi:10.1002/jcla.23016
• 14. Wu L, Zou S, Wang C, Tan X, Yu M. Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio in Chinese Han population from Chaoshan region in South China. BMC Cardiovasc. 2019;19:125. doi:10.1186/s12872-019-1110-7
• 15. Gan L, Sun T, Li B, et al. Serum miR-146a and miR-150 as potential new biomarkers for hip fracture-induced acute lung injury. Mediators Inflamm. 2018;2018:8101359. doi:10.1155/2018/8101359
• 16. Blanco JF da, Casa C, Pablos-Hernández C, González-Ramírez A, Julián-Enríquez JM, Díaz-Álvarez A. 30-day mortality after hip fracture surgery: Influence of postoperative factors. PLoS One. 2021;16:e0246963. doi:10.1371/journal.pone.0246963
• 17. Li S, Zhang J, Zheng H, Wang X, Liu Z, Sun T. Prognostic role of serum albumin, total lymphocyte count, and mini nutritional assessment on outcomes after geriatric hip fracture surgery: A Meta-analysis and systematic review. J Arthroplast. 2019;34:1287-1296. doi:10.1016/j.arth.2019.02.003
• 18. Galivanche AR, Kebaish KJ, Adrados M, et al. Postoperative pressure ulcers after geriatric hip fracture surgery are predicted by defined preoperative comorbidities and postoperative complications. J Am Acad Orthop Surg. 2020;28:342-351. doi:10.5435/jaaos-d-19-00104
• 19. Wang Z, Wang H, Yang L, Jiang W, Chen X, Liu Y. High platelet-to-lymphocyte ratio predicts poor survival of elderly patients with hip fracture. Int Orthop. 2021;45:13-21. doi:10.1007/s00264-020-04833-1
• 20. Forget P, Moreau N, Engel H, et al. The neutrophil-to-lymphocyte ratio (NLR) after surgery for hip fracture (HF). Arch Gerontol Geriatr. 2015;60:366-71. doi: 10.1016/j.archger.2014.11.008
• 21. Wang ZC, Jiang W, Chen X, Yang L, Wang H, Liu YH. Systemic immune-inflammation index independently predicts poor survival of older adults with hip fracture: A prospective cohort study. BMC Geriatr. 2021;21:155. doi:10.1186/s12877-021-02102-3