Objective: In our study the factors related to anesthesia and peroperative variables associated with postoperative mortality among patients aged ≥65 years who had undergone orthopedic surgery were assessed. Methods: Reports on patients aged ≥65 years who had undergone orthopedic surgery between 2015 and 2017 were investigated retrospectively. Results: A total of 135 patients were included in the study. The operations comprised implanta- tions of total hip prosthesis in 26%, total knee prosthesis in 18%, fixation of lower extremity fractures in 24, and upper extremity fractures in 14%, and amputation surgery in 17% of the patients. The postoperative mortality rates were highest (76.9%) among patients who underwent amputation surgery (p
Amaç: Çalışmamızda, ortopedik cerrahi uygulanan 65 yaş ve üstü hastalarda postoperatif mortalite ile ilişkili peroperatif değişkenler ve anestezi ile ilişkili faktörler değerlendirildi. Yöntem: 2015-2017 yılları arasında ortopedik cerrahi geçiren ≥65 yaş hasta kayıtları retrospektif olarak incelendi. Bulgular: Araştırmaya 135 hasta dahil edildi. Ameliyatların %26’sını total kalça protezi, %24’ünü alt ekstremite kırığı, %18’ini total diz protezi, %17’sini ampütasyon cerrahisi ve %14’ünü üst ekstremite kırığı oluşturuyordu. Amputasyon cerrahisi geçirenlerde postoperatif mortalite oranı (%76.9) en yüksekti (p
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Etzioni DA, Liu JH, Maggard MA, Ko CY. The aging popu- lation and its impact on the surgery workforce. Ann Surg. 2003;238:170-7. https://doi.org/10.1097/01.SLA.0000081085.98792.3d
Partridge JS, Harari D, Martin FC, Dhesi JK. The impact of pre-operative comprehensive geriatric assessment on postoperative outcomes in older patients undergo- ing scheduled surgery: a systematic review. Anaesthesia. 2014;1:8-16. https://doi.org/10.1111/anae.12494
Karademir G, Bilgin Y, Erşen A, et al. Hip fractures in patients older than 75 years old: Retrospective analy- sis for prognostic factors.Int J Surg. 2015;24:101-4. https://doi.org/10.1016/j.ijsu.2015.11.009
Imbelloni LE, Gouveia M, Filho GBM, Silva A. Outcome after Anesthesia and Orthopedic Surgery in Patients Nonagenarians and Centenarians Im J Anesth Clin Res. 2014;5:6. https://doi.org/10.4172/2155-6148.1000411
Bilsel K, Erdil M, Gulabi D, Elmadag M, Cengiz O, Sen C. Factors affecting mortality after hip fracture surgery: a retrospective analysis of 578 patients. Eur J Orthop Surg Traumatol. 2013;23:895-900. https://doi.org/10.1007/s00590-012-1104-y
Atay T, Ceylan BC, Özmeriç A, Eroğlu F, Yavuz L, Heybeli N, et al. The Effects of Related Factors on One- and Two-Year Mortality after a Hip Fracture in Elderly Turkish Patients. Trakya Univ Tip Fak Derg. 2010;27:127- 31.
Thomas DR, Ritchie CS. Preoperative assessment of older adults. J Am Geriatr Soc. 1995;43:811-21. https://doi.org/10.1111/j.1532-5415.1995.tb07058.x
Miller DL. Perioperative care of the elderly patient: special considerations. Cleve Clin J Med. 1995;62:383- 90. https://doi.org/10.3949/ccjm.62.6.383
Karaman S, Karaman T, Doğru S, Şahin A, Arıcı S. The effects of anesthsia techniques on mobidity-mortality in geriatric patients underwent orthopedic surgery Journal of Contemporary Medicine. 2014;4:143-50.
Endo Y, Aharonoff GB, Zuckerman JD, Egol KA, Koval KJ. Gender differences in patients with hip fracture: a greater risk of morbidity and mortality in men. J Orthop Trauma. 2005;19:29-35. https://doi.org/10.1097/00005131-200501000-00006
Forsén L, Sogaard AJ, Meyer HE, Edna T, Kopjar B. Survival after hip fracture: short- and long-term excess mortality according toage and gender. Osteoporos Int. 1999;10:73-8. https://doi.org/10.1007/s001980050197
Chung JY, Chang WY, Lin TW, et al. An analysis of surgi- cal outcomes in patients aged 80 years and older. Acta Anaesthesiol Taiwan. 2014;52:153-8. https://doi.org/10.1016/j.aat.2014.09.003
Haentjens P, Magaziner J, Colón-Emeric CS, et al. Meta- analysis: excess mortality after hip fracture among older women and men. Ann Intern Med. 2010;152:380- 90. https://doi.org/10.7326/0003-4819-152-6-201003160- 00008
Owens WD, Felts JA, Spitznagel EL Jr. ASA physical status classifications: a study of consistency of ratings. Anesthesiology. 1978;49:239-43. https://doi.org/10.1097/00000542-197810000-00003
Radcliff TA, Henderson WG, Stoner TJ, Khuri SF, Dohm M, Hutt E. Patient Risk Factors, Operative Care, and Outcomes Among Older Community-Dwelling Male Veterans with Hip Fracture. J Bone Joint Surg Am. 2008;90:34-42. https://doi.org/10.2106/JBJS.G.00065
Peled E, Keren Y, Halachmi S, et al. Patients aged 80 and older undergoing orthopedic or urologic surgery: a prospective study focusing on perioperative morbidity and mortality Gerontology. 2009;55:517-22. https://doi.org/10.1159/000235617
Le Manach Y, Collins G, Bhandari M, et al. Outcomes after hip fracture surgery compared with elective total hip replacement. JAMA. 2015;314:1159-66. https://doi.org/10.1001/jama.2015.10842
Casaletto JA, Gatt R. Post-operative mortality related to waiting time for hip fracture surgery. Injury. 2004;35:114-20. https://doi.org/10.1016/S0020-1383(03)00210-9
de Palma L, Torcianti M, Meco L, Catalani A, Marinelli M. Operative delay and mortality in elderly patients with hip fracture: an observational study. Eur J Orthop Surg Traumatol. 2014;24:783-8. https://doi.org/10.1007/s00590-013-1241-y
Svensson O, Stromberg L, Ohlen G, Lindgren U. Prediction of the outcome after hip fracture in elderly patients. J Bone Joint Surg. 1996;78:115-8. https://doi.org/10.1302/0301-620X.78B1.0780115
Roche JJ, Wenn RT, Sahota O, Moran CG. Effect of comorbidities and postoperative complications on mortality after hip fracture in elderly people: prospec- tive observational cohort study. BMJ. 2005;331:1374. https://doi.org/10.1136/bmj.38643.663843.55
Kuo FC, Hsu CH, Chen WS, Wang JW. Total knee art- hroplasty in carefully selected patients aged 80 years or older. J Orthop Surg Res. 2014;9:61. https://doi.org/10.1186/s13018-014-0061-z
Carson JL, Duff A, Berlin JA, et al. Perioperative blood transfusion and postoperative mortality. JAMA. 1998;279:199-205. https://doi.org/10.1001/jama.279.3.199
Gruson KI, Aharonoff GB, Egol KA, Zuckerman JD, Koval KJ. The relationship between admission hemoglobin level and outcome after hip fracture. J Orthop Trauma. 2002;16:39-44. https://doi.org/10.1097/00005131-200201000-00009
Zuckerman JD, Skovron ML, Koval KJ, Aharonoff G, Frankel VH. Postoperative complications and mortality associated with operative delay in older patients who have a fracture of the hip. J Bone Joint Surg Am. 1995;77:1551-6. https://doi.org/10.2106/00004623-199510000-00010
Simunovic N, Devereaux PJ, Sprague S, et al. Effect of early surgery after hip fracture on mortality and comp- lications: systematic review and meta-analysis. CMAJ. 2010;182:1609-16. https://doi.org/10.1503/cmaj.092220
Aharonoff GB, Koval KJ, Skovron ML, Zuckerman JD. Hip fractures in the elderly: predictors of one year mortality. J Orthop Trauma. 1997;11:162-5. https://doi.org/10.1097/00005131-199704000-00004
Khasraghi FA, Lee EJ, Christmas C, Wenz JF. The econo- mic impact of medical complications in geriatric pati- ents with hip fracture. Orthopedics. 2003;26:49-53.
Peled E, Barak M, Keren Y, Soudry M, Norman D. Predictors for Adverse Outcome in Patients Aged 80 Years and Older Undergoing Emergent Hip Surgery. Surgical Science. 2011;2:463-7. https://doi.org/10.4236/ss.2011.210102
Zeltzer J, Mitchell RJ, Toson B, Harris IA, Ahmad L, Close J. Orthogeriatric services associated with lower 30-day mortality for older patients who undergo surgery for hip fracture. Med J Aust. 2014;201:409-11. https://doi.org/10.5694/mja14.00055