TOLGA ATAY, Gökçe Berit CEYLAN, Ahmet ÖZMERİÇ, FÜSUN EROĞLU, Lütfi YAVUZ, NURETTİN HEYBELİ, Metin Lütfi BAYDAR

The effects of related factors on one- and two-year mortality after a hip fracture in elderly Turkish patients

Amaç: Kalça kırıkları ileri yaşların fonksiyon kaybı ve ölüm ile sonuçlanabilen ciddi sağlık sorunlarındandır. Bu çalışmada amaç kalça kırığı sonrası yaşlı Türk hastalarda değişik risk faktörlerinin mortalite üzerine etkisini ortaya koymaktır. Hastalar ve Yöntemler: 2001-2006 yılları arasında kalça kırığı nedeniyle ameliyat edilmiş, 60 yaş ve üzeri, en az iki yıllık takibi olan 240 hastanın (ort. yaş 76.0±8.2) demografik verileri, ameliyat öncesi süreleri, anestezi ve ASA fiziksel durumu, başvuru albumin düzeyi ile ek morbiditeleri incelendi. Bulgular: Geliş albumin seviyesi 3.45±0.62 g/dl olarak bulundu. Yüz sekiz hastada (%45) albumin düşüklüğü vardı. Albumin düzeyine göre bir ve iki yıl mortalite oranı anlamlı değildi. Ameliyat öncesi yatış süreleri incelendiğinde; birinci yıl mortalitesi erkek hastalarda istatistiksel anlamlı yüksek bulunurken (p=0.015), ikinci yıl mortalitesi bulunmadı. ASA fiziksel skorları yüksek olan hastaların birinci yıl mortaliteleri ile korelasyonunun istatistiksel olarak anlamlı olduğu (p=0.002), ikinci yılda ise olmadığı (p=0.169) saptandı. Cinsiyet incelendiğinde, birinci yıl mortalitesi erkekler için yüksek bulundu (p=0.001). Sonuç: Yüksek ASA skorlarına ek morbiditeler nedeniyle yaşlı hastalarda sık karşılaşılmaktadır. Preoperatif hazırlık sürecinin ASA skoru yüksek olan hastalarda uzun olması nedeniyle ameliyat öncesi süre uzayabilmektedir. Kalça kırığı olan hastaların bir ve iki yıllık mortalite öngörüsünde ASA fiziksel durumu ve ameliyat öncesi gecikmenin önemli belirteçler olduğu görüşündeyiz.

Kalça kırıklı yaşlı Türk hasta grubunda bir ve iki yıllık mortaliteyi etkileyen faktörler

Objectives: Hip fractures are one of the most serious causes of impairment and death in the elderly. The aim of this study is to identify the effects of different risk factors on mortality after a hip fracture in elderly Turkish patients. Patients and Methods: Two-hundred forty patients (>60 years; mean age 76.0±8.2 years) who were operated for fracture of the hip from 2001 to 2006 were investigated. Demographic data, preoperative length of hospital stay, anesthesia type and ASA physical status, albumin level at admission and comorbidities were recorded. Results: Mean albumin level was 3.45±0.62 g/dl. Onehundred eight (45%) had hypoalbuminemia. The difference between mortality rates of normo- and hypoalbuminemic patients were not significant at one and two-year. According to preoperative length of stay; one-year mortality was significantly higher in male patients (p=0.015) while two-year mortality was not. One-year mortality was related with high ASA physical status scores (p=0.002) while two-year mortality was not (p=0.169). According to gender; one-year mortality was found higher in men (p=0.001). Conclusion: Due to comorbidities, high ASA scores are common in elderly patients. Since the preoperative evaluation in high ASA physical status is longer, this may prolong the preoperative hospital stay. Delay after admission and high ASA physical status are important predictors of mortality for elderly hip fracture patients.

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