65 YAŞ ÜSTÜ HASTALARDA FEMUR BOYUN KIRIĞI TEDAVİSİNDE SEMENTLİ VE SEMENTSİZ HEMİARTROPLASTİ SONRASI MORTALİTENİN KARŞILAŞTIRILMASI Comparison of Mortality After Cemented and Cementless Hemiarthroplasty for the Treatment of Femoral Neck Fracture in Patients Aged Over 65 Years Old Mortality After Hemiarthroplasty

Öz

ÖZET Amaç: Bu çalışmanın amacı, femur boyun kırığı nedeniyle sementli veya sementsiz bipolar hemiartroplasti ile tedavi edilmiş 65 yaş ve üstü hastalarda mortalite oranlarını geriye dönük olarak karşılaştırmak ve mortaliteyi etkileyen faktörleri belirlemektir. Gereç ve Yöntem: 2006 ve 2013 yılları arasında, 65 yaş ve üstü olup femur boyun kırığı teşhisiyle bipolar hemiartroplasti ile tedavi edilen hastaların verileri geriye yönelik incelendi. Patolojik kırığı olan, aynı anda birden çok yerde kırığı olan, yetersiz verisi olan ve takibi olmayan hastalar çalışma dışı bırakıldı. Tüm hastaların başvuru anında yaşı, cinsiyeti, kırık tipleri, ek hastalık sayıları, ASA (American Society of Anesthesiologists) skorları, ameliyata kadar beklediği süre hastanemiz elektronik kayıtlarından belirlendi. Ek olarak anestezi tipi, ameliyat süresi, kan transfüzyon miktarı, toplam yatış süresi kayıtlardan incelendi. Hastalar takipte ölenler ve sağ kalanlar olarak gruplandırıldı ve mortalite üzerine etkili temel demografik belirleyiciler karşılaştırıldı. Bulgular: Sementli veya sementsiz bipolar hemiartroplasti uygulanan hastalar klinik özelliklerine göre karşılaştırıldığında sadece kırık tipi açısından gruplar arasında anlamlı fark saptandı (p=0.003). Takip süresince 104 hastadan 65 hasta sağ iken, 39 hasta ölmüştü. Sementli bipolar hemiartroplasti uygulanan hastalarda mortalite oranı istatistiksel olarak anlamlı düzeyde daha yüksekti (p=0.010). Demografik özelliklerden sadece ileri yaşın (p=0.010) mortaliteyi anlamlı olarak artırdığı tespit edildi. Sonuç: Bulgularımız ışığında sementli hemiartroplasti uygulamasının gerekli haller dışında ileri yaş hastalarda mümkün olduğunca tercih edilmemesini öneriyoruz. Anahtar Kelimeler: Hemiartroplasti; femur boyun kırıkları; mortalite oranı; yaşlı ABSTRACT Aim: The aim of this study was to retrospectively compare the mortality rates and determine the factors affecting mortality in patients aged 65 years or older treated with cemented or non-cemented bipolar hemiarthroplasty for femoral neck fractures. Material and Methods: The data of patients who were treated with bipolar hemiarthroplasty between the years of 2006 and 2013 with the diagnosis of femoral neck fracture aged 65 years and over were retrospectively reviewed. Patients with pathological fractures, multiple fractures at the same time, insufficient data and no follow-up were excluded from the study. The age, sex, fracture types, number of additional diseases, ASA (American Society of Anesthesiologists) scores of all patients at the time of admission were determined from the electronic records of our hospital. In addition to that; anesthesia type, operation time, blood transfusion amount, total hospitalization time were examined from records. The patients were grouped as survivors and deceased, and the main demographic determinants of mortality were compared. Results: When the patients who underwent cemented or non-cemented bipolar hemiarthroplasty were compared according to their clinical characteristics, a significant difference was found only between the groups in terms of fracture type (p = 0.003). During the follow-up period, 65 patients of 104 patients were alive and 39 patients died. Mortality rate was significantly higher in patients with cemented bipolar hemiarthroplasty (p = 0.010). According to demographic characteristics, only older age (p = 0.010) significantly increased mortality. Conclusion: In the light of our findings, we suggest that cemented hemiarthroplasty should not be preferred as much as possible in elderly patients except when necessary. Key Words: Hemiarthroplasty; femur neck fractures; mortality rate; elderly

Anahtar Kelimeler

• 65 YAŞ ÜSTÜ HASTALARDA FEMUR BOYUN KIRIĞI TEDAVİSİNDE SEMENTLİ VE SEMENTSİZ HEMİARTROPLASTİ SONRASI MORTALİTENİN KARŞILAŞTIRILMASI Comparison of Mortality After Cemented and Cementless Hemiarthroplasty for the Treatment of Femoral Neck Fracture in Patients Aged Over 65 Years Old Mortality After Hemiarthroplasty

Kaynakça

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