Yaşlı Politravma Hastalarında Mortaliteyi Etkileyen Faktörler Genç Hastalardan Farklı mıdır?

Year 2020, Volume: 27 Issue: 4, 511 - 517, 25.12.2020

Buket Altun Özdemir , Güzelali Özdemir , Niyazi Yaşar Olgun Bingöl , Hakan Ataş , Bülent Çomçalı

https://doi.org/10.17343/sdutfd.757460

Abstract

Amaç: Bu çalışmanın amacı, genç ve yaşlı politravma hastaları arasındaki mortalite farklılıklarını değerlendirmektir.
Gereç ve Yöntem: Bu çalışmada Ocak 2014-Aralık 2018 tarihleri arasında hastanemizde tedavi edilen politravma hastalarının tümü retrospektif olarak incelendi. 65 yaşından küçük hastalar Grup I (n = 60), 65 yaş ve üstü hastalar Grup II (n = 60) olarak sınıflandırıldı. Yaş, cinsiyet, yaralanma mekanizması, yaralanma süresi, yaralanma ciddiyeti skoru (YCS), klinik öncesi hemodinami, hastaneye yatış, operatif tedavi, entübasyon oranı, yoğun bakım ünitesinde (YBÜ) tedavi ve 1 yıllık mortalite analiz edildi. Nötrofil-lenfosit oranı, monosit-lenfosit oranı ve sistemik inflamasyon yanıt indeksi hesaplandı.
Bulgular: Grup I'de yaş ortalaması 36,6 ± 13,0 (18-64), Grup II'de 73,5 ± 7,4 (56-91) idi. Gruplar arasında mortalite oranları arasında fark yoktu. Yaşlı politravma hastaları genellikle yaz aylarında kadın, daha düşük YCS, daha yüksek kan basıncı ve düşük enerjili yaralanma tipinde olma eğilimindedir. Grup I ve Grup II'de mortalite ve YCS skorları arasında istatistiksel olarak anlamlı bir pozitif korelasyon bulundu. Nötrofil-lenfosit oranı, monosit-lenfosit oranı ve sistemik inflamasyon yanıt indeksi skorları açısından yaşlı ve genç politravma hastaları arasında istatistiksel olarak anlamlı bir fark bulunmadı.
Sonuç: Yaşlı politravma hastaları sadece yaşlı yetişkinler değildir ve bunlar ile genç hastalar arasında çeşitli farklılıklar vardır. Yaşlı politravma hastalarının tedavisinin karar verme sürecinde mevcut farklılıkların göz önünde bulundurulması gerekmektedir.

Keywords

Yaşlı politravma, mortalite, politravma

Are the Factors Affecting Mortality in Elderly Polytrauma Patients Different from Those Affecting Younger Patients?

Abstract

Objectives: The purpose of this study was to evaluate the differences in mortality between young and elderly polytrauma patients.
Materials and Methods: In the present study, all consecutive polytrauma patients treated at our hospital between January 2014 and December 2018 were reviewed retrospectively. Patients younger than 65 years old were classified as Group I (n = 60), and patients aged 65 years and older were classified as Group II (n = 60). Age, gender, mechanism of injury, time of injury, injury severity score (ISS), preclinical hemodynamics, hospitalization, operative treatment, intubation rate, intensive care unit (ICU) treatment, and 1-year mortality were analyzed. The neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and systemic inflammation response index (SIRI) were calculated.
Results: The mean age was 36.6 ± 13.0 (18–64) years in Group I and 73.5 ± 7.4 (56–91) years in Group II. There was no difference in mortality rates between groups. Elderly polytrauma patients tend to be female, and lower ISS and higher blood pressure, as well as low-energy injury types, typically in the summer. A statistically significant positive correlation was found between mortality and ISS scores in both Group I and Group II. There was no statistically significant difference was found between elderly and younger polytrauma patients in terms of NLR, MLR, and SIRI scores.
Conclusion: Elderly polytrauma patients are not just older adults, and there are several differences between them and their younger counterparts. The existing differences in the treatment of elderly polytrauma patients need to be considered during decision making.

Keywords

Elderly polytrauma, mortality, polytrauma

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