Predictors of Early Mortality in Geriatric Patients after Hemiarthroplasty for Femoral Neck Fracture

Yıl 2020, Cilt: 4 Sayı: 3, 220 - 225, 29.10.2020

Oğuzhan Tanoğlu , Gökhun Arıcan , Ahmet Özmeriç , Özgür Şahin Serkan İltar , Bahadır Alemdaroglu

https://doi.org/10.30565/medalanya.725992

Cited By: 4

Öz

Aim: Hemiarthroplasty is an appropriate treatment option for hip fractures that provides early mobilization, and good functional results. In the available literature, there are few studies that particulary investigate the risk factors affecting the 30-day mortality after hemiarthroplasty in geriatric patients with hip fractures. This study aimed to determine patient-related factors and biochemical predictors, which were easily accessible, inexpensive, and routinely examined in the perioperative period of 30-day mortality in geriatric patients after hemiarthroplasty for femoral neck fractures.

Methods: We enrolled 169 patients in our study, retrospectively. Age, body mass index, hospitalization time from admission to surgery, total hospitalization time, comorbidities, American Society of Anesthesiologists scores, blood transfusions, anticoagulant medications, albumin and plasma replacements, preoperative and postoperative hemogram, and biochemical tests were analyzed to determine the major predictors of 30-day mortality.

Results: The 30-day mortality rate was 14.2%. Multivariate analysis indicated increased age (>80 years of age) (1.095 odds ratio, p = 0.029), American Society of Anesthesiologists score (3.584 odds ratio, p = 0.007), and postoperative creatinine level (2.845 odds ratio, p = 0.001) as the major predictors of 30-day mortality after hemiarthroplasty for femoral neck fractures in geriatric patients.

Conclusion: Older age (>80 years of age), higher American Society of Anesthesiologists scores (ASA score 3 or 4) and increased postoperative creatinine levels were associated with an increased risk of 30-day mortality.

Anahtar Kelimeler

femoral neck fractures, hip fractures, creatinine, hip replacement arthroplasty, osteoporotic fractures, mortality

Teşekkür

Authors, thanks to Yusuf Kemal Arslan, PhD, Erzincan University Faculty of Medicine, Department of Biostatistics for their contribution.

Femur Boyun Kırığı nedeniyle Hemartroplasti Uygulanan Yaşlı hastalarda, Erken Mortalitenin Öngörücüleri

Öz

Amaç: Kalça kırıkları tedavisinde uygulanan hemiartroplasti ile erken mobilizasyon ve iyi fonksiyonel sonuçlar elde edilmektedir. Güncel literatürde, kalça kırığı olan geriatrik hastalarda hemiartroplasti sonrası 30 günlük mortaliteye etki eden risk faktörlerini araştıran az sayıda çalışma bulunmaktadır. Bu çalışmamızda, geriatrik femur boyun kırıklarında hemiartroplasti uygulaması sonrası 30 günlük mortaliteye etki eden hasta ile ilişkili faktörler, ucuz, rutin olarak kullanılan ve kolayca ulaşılabilen biyokimyasal belirteçlerin incelenmesi amaçlanmıştır.

Yöntemler: Çalışmamızda 169 hasta retrospektif olarak incelenmiştir. Yaş, vücut kitle indeksi, başvuru - ameliyat arası geçen süre, toplam yatış süreleri, komorbid hastalıklar, Amerikan Anestezi Derneği Skorları, kan transfüzyonu, antikoagülan ilaç kullanımı, albumin ve plazma replasmanları, ameliyat öncesi ve sonrası hemogram ve biyokimya testlerinin 30 günlük mortaliteye etkisi incelenmiştir.

Bulgular: 30 günlük mortalite oranı %14,2 olarak bulunmuştur. Çoklu değişkenler analizi sonucunda; yaş (>80 yaş) (1.095 odds ratio, p = 0.029), Amerikan Anestezi Derneği Skoru (3.584 odds ratio, p = 0.007) ve ameliyat sonrası kreatinin değerleri (2.845 odds ratio, p = 0.001), geriatrik femur boyun kırıkları için uygulanan hemiartroplasti sonrası 30 günlük mortalitenin ana belirleyicileri olarak bulunmuştur.

Sonuç: İleri yaş (>80 yaş), yüksek Amerikan Anestezi Derneği skorları (ASA skoru 3 veya 4) ve artmış ameliyat sonrası kreatinin değerleri, artmış 30 günlük mortalite riski ile ilişkili bulunmuştur.

Anahtar Kelimeler

femur boynu kırıkları, kalça kırıkları, kreatinin, kalça replasman artroplasti, osteoporotik kırıklar, mortalite

Kaynakça

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