Demet LAFLI TUNAY, Murat Türkeün ILGINEL

Kalça protezi ameliyatı yapılan yaşlı hastalarda perioperatif kardiyak risk faktörlerinin postoperatif sonuçlara etkisi

Amaç: Kardiyak risk faktörleri, yaşlı cerrahi hastalarda postoperatif sonuçların en önemli belirleyicilerinden biridir. Bu çalışma, total kalça protezi ameliyatı geçiren yaşlı hastalarda perioperatif kardiyak risk faktörlerinin postoperatif olumsuz sonuçlara etkisini belirlemeyi amaçlamıştır. Gereç ve Yöntem: Bu çalışmada, 2014-2019 yılları arasında Çukurova Üniversitesi Hastanesinde total kalça protezi ameliyatı geçiren 65 yaş ve üstü hastalar retrospektif olarak incelendi. Çalışmanın birincil sonuç ölçütleri postoperatif olumsuz sonuçlar ve mortalite oranıydı. Bulgular: Hastanemizin beş yıllık tecrübesi dahilinde olan 223 total kalça protezi cerrahisi hastası tarandı. Hastaların %34,5'inde postoperatif kardiyak, pulmoner, serebral ve enfeksiyöz morbidite ile sistemik inflamatuar yanıt sendromu vardı ve hastane içi ölüm oranı %2,2 idi. Çok değişkenli analizde, postoperatif olumsuz sonuçlarla ilişkili perioperatif risk faktörleri arasında Amerikan Anestezistler Topluluğu (ASA)-II fiziksel durumu (aOR 5.63, %95 CI 1.75-18.11), preoperatif zayıf fonksiyonel kapasite (aOR 9,50, 95% GA 3,14-28,79), travmatik kırık (aOR 2,75, %95 GA 1,22-6,24), preoperatif anemi (aOR 2,15, %95 GA 1,05-4,37) ve uzamış cerrahi (aOR 1,02, %95 GA 1,01-1,02) yer almaktaydı. Sonuç: Bu çalışmada, total kalça protezi ameliyatı geçiren yaşlı hastalarda ameliyat öncesi zayıf fonksiyonel kapasite, önceden var olan anemi, travmatik kalça kırığı, ASA II fiziksel durumu, uzamış vaka süresi ile ameliyat sonrası komplikasyon riski arasında anlamlı ilişki belirlendi.

Anahtar Kelimeler:

Kardiyak risk faktörleri, kalça protezi cerrahisi, mortalite, postoperatif morbidite

The effect of perioperative cardiac risk factors on postoperative outcomes in the elderly patients undergoing hip replacement surgery

Purpose: Cardiac risk factors are among the most important determinants of postoperative outcomes in elderly surgical patients. This study aimed to determine the effect of perioperative cardiac risk factors on postoperative adverse outcomes in elderly patients undergoing total hip replacement surgery. Materials and Methods: Patients aged 65 and older who underwent total hip replacement surgery at Cukurova University Hospital between 2014 and 2019 were analyzed retrospectively. The primary outcome measures were postoperative adverse outcomes and mortality rate. Results: Two hundred twenty-three patients with total hip replacement surgery within five years of experience in our hospital were screened. 34.5% had postoperative cardiac, pulmonary, cerebral, and infectious morbidity and systemic inflammatory response syndrome, and the in-hospital mortality rate was 2.2%. On multivariate analysis, perioperative risk factors associated with postoperative adverse outcomes included American Society of Anesthesiologists (ASA) II physical status (aOR 5.63, 95% CI 1.75-18.11), preoperative poor functional capacity (aOR 9.50, 95% CI 3.14-28.79), traumatic fracture (aOR 2.75, 95% CI 1.22-6.24), preoperative anemia (aOR 2.15, 95% CI 1.05-4.37), and prolonged surgery (aOR 1.02, 95% CI 1.01-1.02). Conclusion: A significant relationship was determined between preoperative poor functional capacity, pre-existing anemia, traumatic hip fracture, ASA II physical status, prolonged case duration and the risk of postoperative complications in elderly patients undergoing total hip replacement surgery.

Keywords:

Cardiac risk factors, hip replacement surgery, mortality, postoperative morbidity,

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