Ortopedik cerrahi sonrası erken dönem hastane mortalitesi ve etki eden faktörler

Amaç: Çalışmamızın amacı erken dönem en yüksek hastane mortalitesine sahip ortopedik cerrahi prosedürü ve mortalite üzerine etki eden faktörleri saptamaktır.Gereç ve Yöntem: 1998-2016 yılları arasında ortopedik cerrahi geçirmiş 19.727 hasta çalışmaya dahil edildi. Bu hastalardan ameliyat sonrası dönemde ilk 30 gün içinde hastanede ölen 370 hastanın dosyası tarandı. Genel mortalite ortalamasının üzerinde olan hastalara uygulanan cerrahiler, yaş, cinsiyet, malignite varlığı, koroner arter hastalığı öyküsü, diyabet, hemodiyaliz, geçirilmiş serebrovasküler olay öyküsü, hipertansiyon varlığı ASA değerlendirme skoru ve anestezi şekilleri kaydedildi.Bulgular: Ortopedik cerrahi geçiren 19.727 hastadan 237 (%1.23) hastanın cerrahi sonrası erken dönem hastanede öldüğü saptadık. Mortalitesi en yüksek 4 cerrahi prosedür; ampütasyon cerrahisinde % 6.35, femur boyun kırığında %5.2, intertrokanterik kalça kırığında %4.2, vertebra cerrahisinde %2.6 olarak bulundu. Mortalite üzerine etki eden faktörler ampütasyon cerrahisi yapılan hastalarda yaş, erkek cinsiyet, hipertansiyon, ameliyatın genel anestezi altında yapılması, ve hastanın hemodiyalize giriyor olması, Yüksek ASA skorunun tüm cerrahi türlerinde istatistiksel olarak anlamlı bulundu.Sonuç: İleri yaş ve buna bağlı ek kronik hastalıklar, ortopedik cerrahi gerektiren hastaların mortalitesini etkilemektedir. Ampütasyon cerrahisi, ve bu cerrahiye sebep olan nedenlerden dolayı, mortalitesi en yüksek ortopedik cerrahidir.

Anahtar Kelimeler:

Ortopedik cerrahi, mortalite, ampütasyon, kalça kırığı

Early period hospital mortality after orthopedic surgery and affecting factors

Purpose: The aim of this study was to determine the factors affecting the mortality and the orthopedic surgical procedure with the highest hospital mortality.Materials and Methods: 19,727 patients who had undergone orthopedic surgery between 1998-2016 were included in the study. Of these patients, 370 patients who died in the hospital within the first 30 days were screened. Surgical procedures for patients with a higher than average mortality, age, gender, presence of malignancy, history of coronary artery disease, diabetes, hemodialysis, cerebrovascular event history, presence of hypertension, The American Society of Anesthesiologists (ASA) assessment score and anesthesia patterns were recorded.Results: Of 19,727 patients undergoing orthopedic surgery, 237 (1.23%) patients died early in the hospital after surgery. 4 surgical procedures with the highest mortality rate; It was found 6.35% in amputation surgery, 5.2% in femoral neck fracture, 4.2% in intertrochanteric hip fracture and 2.6% in vertabra surgery. Factors affecting the mortality were age, male gender, hypertension, having general anesthesia, having amputation surgery and having hemodialysis. ASA score was statistically significant in mortality all surgical types.Conclusion: Amputation is the most deadly orthopedic surgery in the early period. comorbid chronic diseases are the most important factors affecting mortality in orthopedic surgery.

Keywords:

Orthopedic surgery, mortality, amputation, hip fracture,

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