HIP FRACTURES TREATED WITH HEMIARTHROPLASTY: INDICATORS OF MORTALITY IN PATIENTS OLDER THAN 85 YEARS

Year 2017, , 141 - 145, 16.10.2017

Mesut Tahta Tahir Öztürk Cem Özcan Tuğrul Bulut Eyüp Çağatay Zengin Muhittin Şener

https://doi.org/10.18229/kocatepetip.368682

Abstract

OBJECTIVE: The aim of this study was to determine the
preoperative risk factors of all-cause mortality in the
small but very challenging group of hip fracture patients
aged over 85 years.

MATERIALS AND METHODS: Data was gathered retrospectively
on patients aged over 85 years with a diagnosis
of hip fracture. Subsequent survival was determined.
The date of death was recorded (If present). The selected
patients were separated into 2 groups: Group1 who had
died within 1 year (n=46) and group2 who had survived
(n=83).The two groups were compared in respect of age,
gender, operating time, the time from initial trauma to
surgery, total hospitalization duration, American Society
of Anesthesiologists score, cardiac ejection fraction, type
of fracture, application of cemented or uncemented
prosthesis and number of comorbid diseases.

RESULTS: The mean age of the patients in Group 1 was
determined to be significantly higher (p=0.011). The rate
of male mortality was significantly higher (p=0.047). The
rate of mortality of patients with cemented hemiarthroplasty
was significantly higher (p=0.038). No difference
was determined between the groups in respect of mean
ASA scores (p=0.352), total hospitalization duration
(p=0.120),the time from trauma to surgery (p=0.531) or
ejection fraction (p=0.484). No significance was determined
between the groups in respect of the presence and
number of comorbid diseases.

CONCLUSIONS: The mortality rate of older male patients
aged over 85 years with cemented prosthesis applied for
hip fracture was higher. As the only parameter, which can
be modified, uncemented systems, should be selected, if
possible for the prosthesis to be used.

Keywords

Elderly, Hip fractures

HEMİARTROPLASTİ İLE TEDAVİ EDİLMİŞ 85 YAŞ ÜSTÜ HASTALARDAKİ KALÇA KIRIKLARINDA MORTALİTE GÖSTERGELERİ

Abstract

AMAÇ: Bu çalışmada ortopedik cerrahlar açısından zorlayıcı
bir popülasyon olan 85 yaş üstündeki hastalardaki
kalça kırığı olgularında, mortalite riskinin tespiti için preoperatif
risk faktörlerinin belirlenmesi amaçlanmıştır.

GEREÇ VE YÖNTEM: Kalça kırığı tanısıyla servisimize
yatırılarak tedavi ve takip edilen 85 yaş üstündeki
hastaların bilgileri hastane kayıtlarından retrospektif
olarak toplandı. Hastaların sağkalım durumları ve
hayatını kaybetmişse ölüm tarihleri tespit edildi.
Seçilmiş hastalardan hayatını kaybeden 46 hasta grup 1
olarak adlandırılırken; sağ kalan 83 hasta grup 2 olarak
adlandırıldı. Her iki grup yaş, cinsiyet, ameliyat süresi,
ameliyat olana kadar geçen süre, hastanede toplam
yatış süresi, American Society of Anesthesiologists skoru,
kardiyak ejeksiyon fraksiyonu (EF), kırık tipi, protezin
çimentolu / çimentosuz olarak uygulanması ve komorbid
faktör varlığı ile sayıları açısından karşılaştırıldı.

BULGULAR: Grup 1’deki hastaların yaş ortalaması daha
yüksekti ve istatistiksel olarak anlamlı idi (p=0.011). Erkeklerdeki
ölüm oranı daha yüksekti ve istatistiksel olarak
anlamlı idi (p=0.047). Çimentolu hemiartroplasti uygulanmış
olanlarda ölüm oranı daha yüksekti ve istatistiksel
olarak anlamlı idi (p=0,038). İki grup arasında ASA skoru
ortalamaları (p=0.352), toplam yatış süresi (p=0.120), yatıştan
ameliyat olana kadar geçen süre (p=0.531), ejeksiyon
fraksiyonları (p=0.484) açısından anlamlı fark yoktu.

SONUÇ: Yaşlı, erkek ve çimentolu protez kullanılmış olan
85 yaş üstü kalça kırıklı hastalarda ölüm oranları daha
yüksektir ve bu hastalarda takip ve tedavide daha dikkatli
olunmalı, tek modifiye edilebilir değişken olan protez
kullanımında mümkünse çimentosuz sistemler tercih
edilmelidir.

Keywords

Kalça kırıkları, Mortalite

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