Yoğun bakım ünitesine kabul edilen kalça ve diz artroplasti hastalarında Modifiye Frailty İndeksi'nin erken mortaliteyi öngörme değeri

Year 2026, Volume: 7 Issue: 1, 1 - 6, 20.02.2026

Merve Hayriye Kocaoglu , Hakan Yılmaz , Çağatay Baltacı , Hakan Kocaoğlu

https://izlik.org/JA53PJ53HH

Abstract

Amaçlar: Kalça ve diz artroplasti işlemlerinin sayısının artmasıyla birlikte, ameliyat sonrası komplikasyonlara yatkınlığı artırabilecek komorbid durumları olan hastaların sayısı da artmaktadır. Amaç, kalça veya diz artroplastisi sonrası 7 gün içinde yoğun bakım ünitesine (YBÜ) yatış endikasyonu gelişen hastalarda ameliyat sonrası erken mortalite ile ameliyat öncesi kırılganlık arasındaki ilişkiyi belirlemektir.

Yöntemler: Bu çalışma, Ekim 2024 ile Ekim 2025 tarihleri arasında tek bir merkezde kalça ve diz artroplastisi geçiren ve ardından ilk hastane yatışları sırasında yoğun bakım ünitesine yatırılması gereken hastaları içeren retrospektif, gözlemsel bir çalışmadır. Modifiye Frailty Endeksi (mFI) tıbbi kayıtlardan hesaplanmış ve ≥0,36 puan kırılganlık olarak tanımlanmıştır.

Sonuçlar: Yoğun bakım ünitesine yatırılan 53 artroplasti hastasının (ortalama yaş 76,4 ± 9,7) 8'inde (15,1%) erken postoperatif mortalite görülmüştür. Kırılganlık, mortalite ile güçlü bir şekilde ilişkiliydi. Kırılgan hastalarda mortalite oranı %38,9 iken, kırılgan olmayan hastalarda bu oran %2,9 idi (p = 0,0013). Bu istatistiksel olarak anlamlı fark 21,64'lük bir odds ratio ve 13,4'lük bir göreceli risk artışına karşılık geliyordu. Mortalite gelişen hastalar, daha yüksek komorbidite sayısı ve mFI değerleri sergilemişlerdir (p =0,007). Ancak yaş, cinsiyet ve cerrahi tipi ile önemli bir ilişki görülmemiştir. Revizyon prosedürleri sayısal olarak daha yüksek mortalite oranları sergilemiş olsa da bu fark istatistiksel olarak anlamlı değildir (p = 0,528).

Sonuç: Frailty (mFI ≥ 0,36) yoğun bakım ünitesine yatırılan artroplasti hastalarında erken postoperatif mortalitenin en güçlü belirleyicisi olarak bulunmuştur. Yaş, cinsiyet ve cerrahi tipi mortalite üzerinde istatistiksel anlamlılık göstermemiştir. Kırılganlık değerlendirmesinin rutin preoperatif değerlendirmelere dahil edilmesi, yüksek riskli hastaların tespit edilmesine ve perioperatif optimizasyona rehberlik edilmesine yardımcı olabilir.

Keywords

kırılganlık , yoğun bakım , artroplasti , revizyon artroplasti , kalça kırığı , mortalite

Ethical Statement

Bu çalışma Ankara Üniversitesi Tıp Fakültesi İnsan Araştırmaları Etik Kurulu tarafından 11/11/2025 tarihinde i09-889-25 karar sayısıyla onaylanmıştır.

Supporting Institution

Yok

Thanks

Yok

Predictive value of Modified Frailty Index for early mortality in hip and knee arthroplasty patients admitted to intensive care unit

https://izlik.org/JA53PJ53HH

Abstract

Aims: With the expanding volume of hip and knee arthroplasty procedures, a growing proportion of patients present with comorbid conditions that may elevate their susceptibility to postoperative complications. The aim of this study was to investigate the relationship between preoperative frailty and early postoperative mortality (defined as death occurring during the ICU stay or within 7 days after surgery) in patients requiring ICU admission following hip or knee arthroplasty.
Methods: This is a retrospective, exploratory study involving patients who underwent hip and knee arthroplasty at a single center between October 2023 and October 2024 and subsequently required intensive care unit admission during their first hospital stay. The 11-item Modified Frailty Index (mFI) was calculated from medical records, and a score of ≥0.36 was defined as frailty.
Results: Of the 53 arthroplasty patients admitted to the ICU (mean age 76.4±9.7 years), early postoperative mortality occurred in 8 individuals (15.1%). Frailty was strongly associated with mortality, with rates of 38.9% in frail patients versus 2.9% in non-frail patients (p=0.0013), corresponding to an odds ratio of 21.64 and a relative risk of 13.4. Individuals who experienced mortality demonstrated significantly higher comorbidity counts and mFI values (both p=0.007), whereas age, sex, and surgical category showed no significant associations. Although revision procedures exhibited numerically higher mortality rates, this difference did not reach statistical significance (p=0.528).
Conclusion: Frailty (mFI≥0.36) emerged as a strong predictor of early postoperative mortality within 7 days after surgery in ICU-admitted arthroplasty patients, exceeding the associations observed for age, sex, and surgical category. Incorporating frailty assessment into routine preoperative evaluations could help to identify high-risk individuals and guide perioperative optimization.

Keywords

Frailty , intensive care unit , arthroplasty , revision arthroplasty , hip fracture , mortality

Ethical Statement

The institutional review board of Ankara University Faculty of Medicine reviewed and approved this study. (approval number: İ09-889-25, date:11.11.2025)N/

Supporting Institution

N/A

Thanks

N/A

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