One-Year Mortality Rates of Patients with Surgically Treated Hip Fractures over the Age of 65

Öz

Aim: Fractures of the hip are frequently seen in the elderly patients and closely related to severe morbidity, disability, and even increased mortality. The aim of this study was to evaluate the first year mortality rate and the factors affecting this in the patients with surgically treated hip fractures.

Material and Methods: In this retrospective study, 164 patients aged over 65 years who had undergone surgery in our clinics for isolated intertrochanteric femur or femoral neck fractures between October 2014 and February 2018 were evaluated. The necessary information such as age, gender, type of fracture and applied implant, the times between hospitalization/surgery and surgery/discharge were obtained from the archive records. In addition, the patients were contacted by phone and the death times (if they died) were learned. Patients were divided into two groups as who died in the first year after surgery and survived; and then factors affecting the mortality were analyzed comparatively.

Results: This study included 138 patients who meet eligibility criteria. One year mortality rate after surgery was 21.73%. The mean age of the death group (85.97±7.49) was statistically significantly higher than the survival group (79.02±8.92) (p=0.0001). The ratio of the female patients in the death group was found to be statistically significantly higher than the survival group (p=0.037). There were not any statistically significant difference between the death and survival groups in terms of fracture and applied implant types (p=0.881 and p=0.101). The mean times between hospitalization/surgery and surgery/discharge were statistically significantly higher in the death group (p=0.034 and p=0.0001).

Conclusion: In this study, the mortality rate in the first year after surgery was found to be 21.73% and the most important factors affecting this rate were determined as advanced age and increased times between hospitalization/surgery and surgery/discharge.

Anahtar Kelimeler

• Hip fractures,death rate,hip replacement arthroplasty,intramedullary nailing

Kalça Kırığı Nedeniyle Cerrahi Tedavi Uygulanan 65 Yaş Üstü Hastaların Bir Yıllık Mortalite Oranları

Öz

Amaç: Yaşlı hastalarda sık gözlenen kalça kırıkları ciddi morbidite, maluliyet ve hatta artmış mortalite ile yakından ilişkilidir. Bu çalışmada kalça kırığı sebebiyle cerrahi tedavi uygulanan hastaların, cerrahiden sonraki ilk bir yılda gözlenen mortalite oranı ve buna etki eden faktörlerin incelenmesi amaçlanmıştır.

Gereç ve Yöntemler: Kliniğimizde Ekim 2014-Şubat 2018 tarihleri arasında izole intertrokanterik femur ya da femur boyun kırıkları nedeniyle cerrahi tedavi uygulanan 65 yaş üzeri 164 hasta geriye dönük olarak incelendi. Arşiv kayıtları üzerinden hastalara ait yaş, cinsiyet, kırık tipi, yatış-cerrahi arası zaman, cerrahi-taburculuk arası zaman ve kırık için uygulanan implant tipi gibi gerekli bilgilere ulaşıldı. Ayrıca hastalara telefon ile ulaşılarak vefat tarihleri (vefat etti iseler) öğrenildi. Hastalar; cerrahi sonrasındaki ilk bir yıl içinde vefat edenler ve yaşayanlar olarak iki gruba ayrıldı ve mortaliteye etki eden faktörler açısından karşılaştırmalı analizler yapıldı.

Bulgular: Çalışmaya kriterlere uygun 138 hasta dahil edildi. Cerrahi sonrası ilk 1 yıldaki ölüm oranı %21,73 olarak bulundu. Vefat edenler grubunun yaş ortalaması (85,97±7,49) yaşayanlar grubundan (79,02±8,92) istatistiksel olarak anlamlı derecede yüksek bulundu (p=0,0001). Vefat edenler grubundaki kadın hasta oranı yaşayanlar grubundan istatistiksel olarak anlamlı derecede yüksek bulundu (p=0,037). Vefat edenler ve yaşayanlar grupları arasında kırık tipi ve uygulanan implant türü açısından anlamlı derecede farklılık gözlenmedi (p=0,881 ve p=0,101). Vefat edenler grubunun yatış-cerrahi arası süre ile cerrahi-taburculuk arası süre ortalamaları yaşayanlar grubundan istatistiksel olarak anlamlı derecede yüksek bulundu (p=0,034 ve p=0,0001).

Sonuç: Bu çalışmada cerrahi sonrası ilk bir yıldaki mortalite oranı %21,73 olarak bulundu ve mortaliteye etki eden en önemli faktörlerin ileri yaş ile artmış yatış-cerrahi ve cerrahi-taburculuk arası süre olduğu tespit edildi.

Anahtar Kelimeler

• Kalça kırıkları,ölüm oranı,kalça replasman artroplasti,intrameduler çivileme

Kaynakça

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