Can the Neutrophil-to-Platelet Ratio Be Used to Predict Postoperative Mortality in Geriatric Patients with Hip Fractures?

Year 2023, Volume: 5 Issue: 3, 175 - 179, 10.10.2023

Tuğçehan Sezer Akman , Hatice Selçuk Kuşderci , Lokman Kehribar , Bahattin Çağdaş Akman , Ahmet Şen

https://doi.org/10.52827/hititmedj.1302044

Abstract

Objective: Hip fracture is a condition frequently encountered in geriatric patients and is correlated with high postoperative mortality and morbidity. Numerous factors may impact mortality, but recent studies have focused on its correlation with inflammation. The neutrophil-to-platelet ratio has been evaluated as a systemic inflammation marker. The aim of our study was to examine the correlation between preoperative neutrophil-to-platelet ratio (NPR) values and postoperative one-year mortality in geriatric patients with hip fractures.
Material and Method: In our retrospective, multicenter study, 50 patients over 65 years of age who had undergone hip fracture surgery under spinal anesthesia were examined. Patients’ preoperative neutrophil-to-platelet ratio values at the time of hospitalization, age, gender, American Society of Anesthesiologists scores, fracture types, comorbidities, durations of surgery, lengths of hospital stay, and survival in the postoperative one-year period were checked.
Results: The mean age of all the patients was 85.44 ± 6.93 years. Of the patients, 60% were female (n = 30), and 40% were male (n = 20). The optimal cut-off value for preoperative neutrophil-to-platelet ratio was specified as 38.286. The length of hospital stay was 8.94 ± 3.05 in the deceased patients and 6.94 ± 2.63 days (p = 0.02) in the surviving group. The mortality rate was higher in men than in women (p = 0.01).
Conclusion: A preoperative neutrophil-to-platelet ratio value over 38.286 is an indicator of postoperative one-year mortality in elderly hip fracture patients. Additionally, length of hospital stay and the male gender were revealed to be correlated with mortality.

Keywords

hip fractures, mortality, geraitrics, inflammation

Kalça Kırığı Olan Geriatrik Hastalarda Postoperatif Mortalite Tahmininde Nötrofil-Platelet Oranı Kullanılabilir mi?

Abstract

Amaç: Kalça kırığı, geriatrik hastalarda sıklıkla karşılaşılan bir durumdur ve yüksek postoperatif mortalite ve morbidite ile ilişkilidir. Mortaliteyi etkileyebilecek çok sayıda faktör vardır, ancak son çalışmalar inflamasyon ile ilişkisine odaklanmıştır. Nötrofil-platelet oranı, sistemik bir inflamasyon belirteci olarak kullanılmaktadır. Çalışmamızın amacı, kalça kırığı olan geriatrik hastalarda ameliyat öncesi nötrofil-platelet oranı (NPR) değerleri ile ameliyat sonrası bir yıllık mortalite arasındaki ilişkiyi incelemektir.
Gereç ve Yöntem: Retrospektif, çok merkezli çalışmamızda spinal anestezi altında kalça kırığı ameliyatı geçirmiş 65 yaş üstü 50 hasta incelendi. Hastaların preoperatif hastaneye yatış anındaki nötrofil-platelet oranı değerleri, yaşları, cinsiyetleri, Amerikan Anesteziyologlar Derneği skorları (ASA), kırık tipleri, komorbiditeleri, cerrahi süreleri, hastanede kalış süreleri ve postoperatif bir yıllık dönemde sağkalımları incelendi.
Bulgular: Tüm hastaların ortalama yaşı 85,44 ± 6,93 idi. Hastaların %60’ı kadın (n=30), %40’ı erkekti (n=20). Ameliyat öncesi nötrofil- platelet oranı için optimal cut-off değeri 38.286 olarak belirlendi. Hastanede kalış süresi ölen hastalarda 8,94 ± 3,05, yaşayan grupta 6,94 ± 2,63 gün (p=0,02) bulundu. Erkeklerde ölüm oranı kadınlara göre daha yüksekti (p=0,01).
Sonuç: Ameliyat öncesi nötrofil-platelet oranı değerinin 38.286’nın üzerinde olması, yaşlı kalça kırığı hastalarında ameliyat sonrası bir yıllık mortalitenin göstergesi olarak bulundu. Ayrıca hastanede kalış süresi ve erkek cinsiyetin mortalite ile ilişkili olduğu kanıtlanmıştır.

Keywords

kalça kırığı, mortalite, geriatri, inflamasyon

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