Bahattin TUNCALI, Hakan BOYA, Şükrü ARAÇ

TOTAL DİZ PROTEZİ UYGULANAN HASTALARDA OBESİTE VARLIĞININ İNTRAOPERATİF VE ERKEN POSTOPERATİF (HASTANEDE) KOMPLİKASONLAR ÜZERİNE OLAN ETKİSİ

AMAÇ: Hem obezitenin hem de total diz protezi (TDP) uygulamasının artışı ile birlikte, son yıllarda obez hastalarda TDP uygulama sayısı artmıştır. Obezitenin TDP uygulamasında izlenen komplikasyonlar için risk faktörü olup olmadığı tartışmalıdır. Bu çalışmanın amacı TDP uygulaması yapılan hastalarda intraoperatif ve erken postoperatif (hastanede) komplikasyonlar üzerine obezitenin etkisini araştırmaktır.GEREÇ VE YÖNTEM: Hastalar vücut kitle endeksine göre 2 gruba ayrıldı; Grup 1: obez (Vücut kitle endeksi: VKE > 30 kg/m2), Grup 2: Obez olmayan (VKE ≤30 kg/m2). Hastaların dosyaları 4 farklı yönden değerlendirildi (Demografik veriler; Preoperatif, İntraoperatif, Postoperatif bulgular). Parametrik verilerin analizinde T-test, non-parametrik verilerin analizinde Ki-kare testi kullanıldı. P<0.05 değeri anlamlı kabul edildi.BULGULAR: Obez olan ve olmayan hastalar arasında hastanede yatış, operasyon ve turnike süreleri, kan transfüzyonu sayısı, ASA (American Society of Anesthesiologists) puanları, İskemik kalp hastalığı, diyabet varlığı, lokal cilt komplikasyonları ve derin ven trombozu, sepsis, pulmoner emboli, mortalite gibi sistemik komplikasyonlar yönünden fark yoktu. Ancak obez grupta hipertansiyon, hipotiroidizm ve obstrüktif uyku apnesi istatistiksel olarak anlamlı oranda daha sık izlendi.SONUÇ: Obez olan ve olmayan hastalara uygulanan TDP olguları arasında lokal ve sistemik komplikasyonlar yönünden fark yoktur.

Anahtar Kelimeler:

Diz, Artroplasti, Komplikasyon, Obezite, Yatan hasta

THE EFFECT OF OBESITY ON INTRAOPERATIVE AND EARLY POSTOPERATIVE (IN HOSPITAL) COMPLICATIONS IN PATIENTS UNDERGOING TOTAL PROSTHESIS

OBJECTIVE: Due to the increase in both obesity and total knee prosthesis arthroplasty (TKA), the number of TKA applications in obese patients has increased in recent years. However, it is debatable whether obesity is a risk factor for the complications observed in TKA. The aim of this study is to investigate the effect of obesity on intraoperative and early postoperative (in hospital) complications in patients with TKA.MATERIAL AND METHODS: Patients were divided into 2 groups according to body mass index; Group 1: obese patients (Body mass index: BMI> 30 kg/m2), Group 2: non-obese patients (BMI≤30 kg/m2). Patient files were examined from 4 different perspectives (Demographic data, Preoperative features, Intraoperative features, Postoperative features). T-test was used in the analysis of parametric data, and Chi-square test was used in the analysis of non-parametric data. A value of P<0.05 was considered significant.RESULTS: There was no statistically significant difference between the obese and non-obese patients in respect of the length of hospital stay, the operation time, the tourniquet time, the number of blood transfusions, presence of ischemic heart disease, diabetes, ASA scores, local skin complications, and systemic complications such as deep vein thrombosis, sepsis, pulmonary embolism and mortality. However, a statistically significant difference was found in presence of hypertension, hypothyroidism, and obstructive sleep apnea in the obese group.CONCLUSIONS: There is no difference in terms of local and systemic complications in obese and non-obese patients undergoing TKA.

Keywords:

Knee, Arthroplasty, Complication, Obesity, Inpatient,

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