Frailty and Nursing Care in Orthopedic Surgery Patients

Abstract

Aging is permanent and irreversible as it leads to a decrease in vital functions, organism efficiency and adaptation to environmental factors Improvements in environmental conditions, along with advancements in health and technology have extended life expectancy and led to an increase in the elderly population. Physiological changes such as osteoporosis, sarcopenia, weight loss and chronic inflammation are observed in elderly individuals, the rate of falls increases and orthopedic surgery is frequently required due to trauma. The most common orthopedic surgical intervention in elderly patients is total joint arthroplasty. Frailty is common among orthopedic surgery patients and is associated with postoperative complications. Frailty is a biological condition that occurs accompanies aging. As a geriatric syndrome, frailty leads to a decrease in physiological reserves. Frail elderly patients experience problems such as sarcopenia, weight loss, weakness, decreased tolerance to stress, and burnout. Therefore, the risk of postoperative complications increases in these patients. Physical and psychological problems such as deep vein thrombosis, surgical site infection, urinary tract infection, and delirium are the most common postoperative complications. Moreover, frailty is an important cause of morbidity and mortality in the 30- day postoperative period in elderly patients. Therefore, diagnosing frailty in elderly patients, evaluating risk factors, and providing individualized nursing care are essential. The aim of the review prepared in this direction is to provide information about the diagnosis and nursing management of frailty in elderly patients undergoing orthopedic surgery.

Keywords

• Geriatrics
• nursing care
• frailty
• total joint arthroplasty.

Ortopedik Cerrahi Hastalarında Kırılganlık ve Hemşirelik Bakımı

Abstract

Yaşlılık, yaşamsal fonksiyonların, organizma verimliliğinin ve çevresel faktörlere uyumun azalmasına neden olduğundan, sürekli ve geri dönüşsüzdür. Çevresel koşulların iyileşmesi, sağlık ve teknoloji alanındaki gelişmeler yaşam süresini uzatmış ve yaşlı nüfusun artmasına neden olmuştur. Yaşlı bireylerde osteoporoz, sarkopeni, kilo kaybı, kronik inflamasyon gibi fizyolojik değişiklikler görülmekte, düşme oranı artmakta ve travma nedeniyle ortopedik cerrahi girişim sık uygulanmaktadır. Yaşlı hastalarda en sık uygulanan ortopedik cerrahi girişim ise total eklem artroplastisidir. Ortopedik cerrahi hastalarında kırılganlık yaygındır ve ameliyat sonrası komplikasyonlar ile ilişkilidir. Kırılganlık, yaşlanma ile oluşan biyolojik bir durumdur. Geriatrik bir sendrom olan kırılganlık, fizyolojik rezervlerin azalmasına neden olmaktadır. Kırılgan yaşlı hastalarda sarkopeni, kilo kaybı, güçsüzlük, strese karşı toleransta azalma ve tükenmişlik gibi problemler yaşanmaktadır. Bu nedenle bu hastalarda ameliyat sonrası komplikasyon riski artmaktadır. Derin ven trombozu, cerrahi alan enfeksiyonu, idrar yolu enfeksiyonu, deliryum gibi fiziksel ve psikolojik problemler en sık görülen ameliyat sonrası komplikasyonlardır. Ayrıca kırılganlık yaşlı hastalarda ameliyat sonrası 30 günlük dönemdeki morbidite ve mortalitenin önemli bir nedenidir. Bu nedenle yaşlı hastalarda kırılganlığın tanılanması, risk faktörlerinin değerlendirilmesi ve bireyselleştirilmiş hemşirelik bakımının sağlanması gereklidir. Bu doğrultuda hazırlanan bu derlemenin amacı, ortopedik cerrahi geçiren yaşlı hastalarda kırılganlığın tanılanması ve hemşirelik yönetimi hakkında bilgi vermektir.

Keywords

• Geriatri
• hemşirelik bakımı
• kırılganlık
• total eklem artroplastisi

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