İRFAN ÖZTÜRK, Serdar TOKER, Erdem ERTÜRER, Bülent AKSOY, Faik SEÇKİN

Kalça kırığı nedeniyle ameliyat edilen 65 yaş üstü hastalarda mortaliteye etki eden risk faktörlerinin değerlendirilmesi

Amaç: Bu çalışmada kalça kırığı nedeniyle ameliyat edilen 65 yaş üstü hastalarda mortalite oranları ile ameliyat öncesi medikal durum ve yaşamsal faktörler arasındaki ilişki değerlendirildi. Çalışma planı: Çalışmada, kalça kırığı nedeniyle ameliyat edilen ve 36 aylık takip verileri bulunan 92 hasta (56 kadın, 36 erkek) değerlendirildi. Kadın hastaların yaş ortalaması 76 (dağılım 65-96), erkek hastaların yaş ortalaması 74 (dağılım 65-92) idi. Kırıklar 54 hastada (%58.7) intertrokanterik bölgede, 38 hastada (%41.3) femur boynunda idi. Tüm hastalar “Şişli Etfal” risk faktörleri skorlamasına göre düşük (n=23, %25), orta (n=45, %48.9) ve yüksek (n=24, %26.1) riskli olarak gruplara ayrıldı. Her bir risk grubunda cinsiyet, kırık öncesi yürüme durumu, bilişsel fonksiyonlar ve ameliyata kadar geçen sürenin mortalite ile ilişkisi değerlendirildi. Sonuçlar: Bir yıllık ölüm oranları, düşük risk grubunda %6.9, orta risk grubunda %31.4, yüksek risk grubunda ise %80 olarak hesaplandı. Skorlama sonuçları ile mortalite oranları anlamlı ilişki gösterdi (r=0.664; p0.05). Yürüteç kullanarak yürüyebilen hastalarda ilk üç ay içindeki ölüm oranı, bir destekle veya tamamen bağımsız yürüyebilen hastalara göre anlamlı derecede yüksek idi (p=0.037). Çıkarımlar: Kalça kırığı ameliyatlarından sonra mortalite oranlarının tahmininde, tüm risk faktörlerini içeren ayrıntılı bir skorlama sisteminin kullanılması tedavinin planlanması yönünden uygun olacaktır.

Anahtar Kelimeler:

Femur boynu kırıkları, Kalça kırıkları, Eş tanı, Ameliyat sonrası komplikasyonlar, Risk faktörleri, Yaşlı, Yaşam kalitesi, Yaşlı, 80 ve üzeri, Femur başı, Yaşlılar için sağlık hizmetleri, Ölüm oranı

Analysis of risk factors affecting mortality in elderly patients (aged over 65 years) operated on for hip fractures

Objectives: We analyzed the relationship between mortality rates and preoperative medical conditions and vital factors in elderly patients (aged over 65 years) operated on for hip fractures. Methods: The study included 92 patients (56 females, 36 males) who were operated on for hip fractures and had follow- up data up to 36 months. The mean age was 76 years (range 65 to 96 years) for women, and 74 years (range 65 to 92 years) for men. The fractures were intertrochanteric in 54 patients (58.7%), and in the femur neck in 38 patients (41.3%). The patients were divided into three risk groups, namely, low (n=23, 25%), moderate (n=45, 48.9%), and high (n=24, 26.1%), according to our institutional Şişli Etfal risk factor assessment scale. Relationships were analyzed between mortality and sex, preinjury ambulation level, cognitive functions, and time to surgery in each risk group. Results: One-year mortality rates were 6.9%, 31.4%, and 80% in low-, moderate-, and high-risk groups, respectively. The risk scores were significantly correlated with mortality rates (r=0.664; p<0.05). Thirty-four female patients (60.7%) and 18 male patients (50%) were dead at the end of 36 months. No significant relationship was found between mortality rates and sex, cognitive functions, and time to surgery (p>0.05). Mortality within the first three postoperative months among patients who could only ambulate with a walker preoperatively was significantly higher than those who could walk independently or with an aid (p=0.037). Conclusion: A risk assessment system covering all risk factors to estimate postoperative mortality following surgery for hip fractures would be helpful in planning treatment.

Keywords:

Femoral Neck Fractures, Hip Fractures, Comorbidity, Postoperative Complications, Risk Factors, Aged, Quality of Life, Aged, 80 and over, Femur Head, Health Services for the Aged, Mortality,

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