Geriatrik Cerrahi Hastalarında Kırılganlık İndeksi D Vitamini Yetersizliği ile İlişkilidir: Prospektif Gözlemsel Çalışma
Amaç: Bu çalışmada elektif cerrahi uygulanan geriatrik hastalarda D vitamini, kırılganlık ve postoperatif sonuçlar arasındaki ilişkiyi araştırmayı amaçladık. Yöntem: Bu prospektif gözlemsel çalışmaya, kalp dışı cerrahi geçir- miş toplam 90 yaşlı hasta dahil edildi. Hastalar kırılganlık indeksi (FI) skoruna göre “Kırılgan olmayan (FI 0), kırılganlık öncesi (FI 1–2) ve kırılgan (FI ≥3)” olarak sınıflandırıldı. Ayrıca hastalar serum D vitamini konsantrasyonuna göre “D vitamini yetersiz grup (n=41) ve D vitamini yeterli grup (n=49)” olmak üzere iki gruba ayrıldı. Hastaların klinik özellikleri ve postoperatif sonuçları gruplar ara- sında karşılaştırıldı. Bulgular: Hastaların ortalama yaşı 75,7 ± 7,6 yıl, yoğun bakım üni- tesine kabul oranı %43,3 ve ameliyat sonrası 30 günlük mortalite oranı %21,1 idi. “D vitamini yetersizliği” grubunda yoğun bakıma yatış anlamlı olarak daha yüksekti (n=24’e karşı n=15, p=0,014). Ayrıca kırılgan hastalar “D vitamini yetersizliği” grubunda anlamlı olarak daha yüksekti (n=19’a karşı n=7, p=0,004). Kırılgan olma- yan hastaların çoğu “D Vitamini yeterli” grubundaydı (n=18’e karşı n=9). Sonuç: Çalışmamızda D vitamini eksikliği olan hastalarda daha yüksek kırılganlık gözlemledik. Ayrıca D vitamini yetersizliği olan ve kırılgan hastalarda postoperatif yoğun bakıma yatış oranı daha yüksekti. Bulgularımız, postoperatif sonuçlarda kırılganlık ve D vi- tamini eksikliğinin önemli bir rol oynadığını göstermektedir.
Frailty Index is Associated with Vitamin D Insufficiency in Geriatric Surgery Patients: A Prospective Observational Study
Objective: In this study, we aimed to investigate the relationship between vitamin D, frailty and postoperative outcomes in geriatric patients undergoing elective surgery. Methods: In this prospective observational study, a total of 90 el- derly patients who had undergone non-cardiac surgery were inc- luded. The patients were classified according to the frailty index (FI) score as “Non-frail (FI 0), Pre-frail (FI 1–2) and Frail (FI ≥3)”. In addition, patients were divided into two groups according to se- rum vitamin D concentration: vitamin D insufficiency group (n=41) and vitamin D sufficiency group (n=49). Clinical characteristics and postoperative outcomes of the patients were compared between the groups. Results: The mean age of the patients was 75.7 ± 7.6 years, the admission rate to Intensive Care Unit (ICU) was 43.3%, and the 30- day mortality rate after surgery was 21.1%. The ICU admission was significantly higher in the “vitamin D insufficiency” group (n=24 versus n=15, p=0.014). In addition, fragility status patients were significantly higher in the “vitamin D insufficiency” group (n=19 versus n=7, p=0.004). Most of the non-frail patients were in the “vitamin D sufficiency” group (n=18 versus n=9). Conclusion: In our study, we observed higher frailty in vitamin D insufficiency patients. In addition, admission to the postoperative ICU was higher in vitamin D insufficiency and frail patients. Our findings show that frailty and vitamin D insufficiency play an im- portant role in postoperative outcomes.
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