Necip GÜVEN, Ramazan Sami AKTAŞ, Tülin TÜRKÖZÜ, Gizem GİZLİ, Abbas TOKYAY, Sevdegul BİLVANİSİ

Acil servise başvuran geriatrik kırıkların yıllara ve mevsimlere göre değerlendirilmesi

Öz Amaç: Günümüzde sanayileşmiş ülkelerin hızla artan ve çeşitlenen yaşlı nüfusa sahip olması ile beraber bu kırıkların görülme sıklığı giderek artmaktadır. Bu çalışmanın amacı geriatrik kırkların görülme sıklığı, yaş, cinsiyet, mevsim ve yıllara göre dağılımını değerlendirmektir. Gereç ve yöntem: 2015-2020 yılları arasında acil servisimize başvuran 65 yaş ve üstü geriatrik kırıklı hastaların en sık görülen kırık lokalizasyonuna göre (kalça, distal önkol, proksimal humerus ve ayakbileği kırıkları) analizleri yapıldı. Bu kırıklar yaş, cinsiyet, mevsimsel özellik ve yıllara göre dağılımları değerlendirildi. Bulgular: Çalışmaya alınan 370 hastanın 168 tanesi erkek 202 tanesi kadın olup yaş ortalaması 79.5 idi. En sık görülen kırık tiplerinin görülme sıklığına göre sırasıyla; kalça (%51.6), distal önkol(%25.1), proksimal humerus (%12.4) ve ayak bileği kırığı (%10.8) olduğu görüldü. Distal önkol kırıklarının kadınlarda erkeklere oranla istatistiksel olarak anlamlı bir şekilde yüksek olduğu (p=0.001), ancak diğer kırıklarda cinsiyetler arasında istatistiksel olarak fark görülmemiştir (p>0.05). Kalça kırıklarının 86 yaş ve üzeri gurubunda anlamlı olarak yüksek olduğu, diğer kırıkların ise 65-75 yaş aralığında daha yüksek olduğu görülmüştür. Tüm kırıklarda mevsimsel bir özellik görülmemiştir. Kalça kırıklarının 2020 yılında en yüksek oranda görülmüştür. Diğer kırıklarda ise yıllar arasında kırık dağılımı açısından fark görülmemiştir. Sonuç: Geriatrik kırıkların sosyal izalosyonda rölatif olarak arttığı ve yöremizde mevsimsel özellik göstermediği sonucuna varılmıştır. Yaşın ilerlemesi ve yaşam beklentisinin daha fazla olması ile mortal olabilecek geriatrik kırıkların insidansının iyi bilinmesi ve pandemi gibi durumlarda bu hastaların hem izolasyonu hem de erken tedavi edilip taburcu edilmesi ile birlikte iyi bir yönetim stratejisi belirlenmesi gerektiği kanaatindeyiz.

Anahtar Kelimeler:

Geriatrik kırıklar, Kalça, Distal önkol, Hava durumu, Yaşlılar

Evaluation of Geriatric Fractures Admitted to the Emergency Department According to Years and Seasons

Abstract Objective: With the rapidly increasing and diversifying elderly population of industrialized countries, the incidence of geriatric fractures is gradually increasing. The aim of this study is to evaluate the distribution of geriatric fractures according to the prevalence, age, sex, season and years. Material and Method: Analyzes of geriatric fractures in patients aged 65 and over who were admitted to our emergency department between 2015 and 2020 were performed according to the most common fracture locations (hip, distal forearm, proximal humerus and ankle). The distribution of these fractures by age, gender, seasonal characteristics and years was evaluated Results: A total of 370 cases (168 male, and 202 female patients) with an average age of 79.5years were included in the study. The most common fracturestypes in order of decreasing frequency were fractures of the hip (51.6%), distal forearm (25.1%), proximal humerus (12.4%) and ankle (10.8%). The incidence of distal forearm fractures was significantly higher in females than males (p = 0.001), but any statistically significant difference was not found between genders regarding other fractures (p> 0.05). It was observed that the incidence of hip fractures was significantly higher in the people aged 86 years and over, while the other fractures were more frequently seen in the 65-75 age group. A seasonal feature was not observed in all fractures. The highest rate of hip fractures was seen in the year 2020. There was no difference in the distribution of other types of fractures over the years Conclusion: It has been concluded that the incidence of geriatric fractures increases relatively in conditions of social isolation and does not show seasonal characteristics in our region. We are of the opinion that a good management strategy should be determined characterized with both the isolation of these patients and their early treatment and discharge in disasters as pandemics, and the incidence of geriatric fractures that can be mortal with advancing age and higher life expectancy should be very well known.

Keywords:

Geriatric fractures, Hip, Distal foream, Weather, Elderly,

PDF

___

References 1.Baidwan NK, Naranje SM. Epidemiology and recent trends of geriatric fractures presenting to the emergency department for United States population from year 2004-2014. Public Health. 2017 Jan;142:64-69.
2. Engelman M, Canudas-Romo V, Agree EM. The implications of increased survivorship for mortality variation in aging populations. Popul Dev Rev 2010;36:511e39.
3. Bonne S, Schuerer DJ. Trauma in the older adult: epidemiology and evolving geriatric trauma principles. Clin Geriatr Med. 2013 Feb;29(1):137-50.
4. Bischoff-Ferrari HA, Orav JE, Barrett JA, Baron JA. Effect of seasonality and weather on fracture risk in individuals 65 years and older. Osteoporos Int. 2007 Sep;18(9):1225-33.
5. Roth T, Kammerlander C, Gosch M, Luger TJ, Blauth M. Outcome in geriatric fracture patients and how it can be improved. Osteoporos Int. 2010 Dec;21(Suppl 4):S615-9.
6. Johnell O, Kanis J. Epidemiology of osteoporotic fractures. Osteoporos Int. 2005 Mar;16 Suppl 2:S3-7.
7. Kanters TA, van de Ree CLP, de Jongh MAC, Gosens T, Hakkaart-van Roijen L. Burden of illness of hip fractures in elderly Dutch patients. Arch Osteoporos. 2020 Jan 3;15(1):11.
8. Borgström F, Karlsson L, Ortsäter G, et al. International Osteoporosis Foundation. Fragility fractures in Europe: burden, management and opportunities. Arch Osteoporos. 2020 Apr 19;15(1):59.
9. Povoroznyuk VV, Grygorieva NV, Kanis JA, et al. Epidemiology of Hip Fractures in Two Regions of Ukraine. J Osteoporos. 2018 Jun 3;2018:7182873.
10. Lewiecki EM, Wright NC, Curtis JR, et al. Hip fracture trends in the United States, 2002 to 2015. Osteoporos Int. 2018 Mar;29(3):717-722.
11. Zakroyeva A, Lesnyak O, Cazac V, et al. Epidemiology of osteoporotic fracture in Moldova and development of a country-specific FRAX model. Arch Osteoporos. 2020 Jan 28;15(1):13.
12. Gül D, Akpancar S. Fractures in Geriatric Cases. Geriatrik Bilimler Dergisi 2019;2:14-9.
13. Johnell O, Kanis JA. An estimate of the worldwide prevalence and disability associated with osteoporotic fractures. Osteoporos Int. 2006;17:1726e33.
14. Hsu RY, Lee Y, Hayda R, DiGiovanni CW, Mor V, Bariteau JT. Morbidity and Mortality Associated with Geriatric Ankle Fractures: A Medicare Part A Claims Database Analysis. J Bone Joint Surg Am. 2015 Nov 4;97(21):1748-55.
15. Serra JA, Garrido G, Vidán M, Marañón E, Brañas F, Ortiz J. Epidemiología de la fractura de cadera en ancianos en España [Epidemiology of hip fractures in the elderly in Spain]. An Med Interna. 2002 Aug;19(8):389-95.
16. Bulajic-Kopjar M. Seasonal variations in incidence of fractures among elderly people. Inj Prev. 2000 Mar;6(1):16-9.
17. Johnson NA, Stirling E, Alexander M, Dias JJ. The relationship between temperature and hip and wrist fracture incidence. Ann R Coll Surg Engl. 2020 May;102(5):348-354.
18. Launonen AP, Lepola V, Saranko A, Flinkkilä T, Laitinen M, Mattila VM. Epidemiology of proximal humerus fractures. Arch Osteoporos. 2015;10:209.
19. Burget F, Foltán O, Kraus J, Kudrna K, Novák M, Ulrych J. Vliv počasí na výskyt zlomenin ve stáří [Influence of the Weather on the Incidence of Fractures in the Elderly]. Acta Chir Orthop Traumatol Cech. 2016;83(4):269-273.
20. Ström O, Borgström F, Kanis JA, et al. Osteoporosis: burden, health care provision and opportunities in the EU: a report prepared in collaboration with the international osteoporosis foundation (IOF) and the European federation of pharmaceutical industry associations (EFPIA). Arch Osteoporos. 2011;6:59–155.
21. Bath PA, Morgan K. Differential risk factor profiles for indoor and outdoor falls in older people living at home in Nottingham, UK. Eur J Epidemiol. 1999 Jan;15(1):65-73.
22. Arafa M, Nesar S, Abu-Jabeh H, Jayme MOR, Kalairajah Y. COVID-19 pandemic and hip fractures: impact and lessons learned. Bone Jt Open. 2020 Sep 4;1(9):530-540.