Frailty Index is Associated with Vitamin D Insufficiency in Geriatric Surgery Patients: A Prospective Observational Study

undefined, AYŞEGÜL; Miniksar, Ökkeş Hakan; honca, tevfik; göçmen, ayşe yeşim

doi:10.54875/jarss.2023.92063

Frailty Index is Associated with Vitamin D Insufficiency in Geriatric Surgery Patients: A Prospective Observational Study

Ökkeş Hakan MİNİKSAR, (Yozgat Bozok Üniversitesi Tıp Fakültesi Anesteziyoloji ve Reanimasyon Anabilim Dalı, Yozgat, Türkiye)

Tevfik HONCA, (Özel İzmir Hastanesi, Biyokimya Bölümü, İzmir, Türkiye)

Aysegul PARLAK CİKRİKCİ, (Yozgat Bozok Üniversitesi Tıp Fakültesi Anesteziyoloji ve Reanimasyon Anabilim Dalı, Yozgat, Türkiye)

Ayşe Yeşim GÖÇMEN (Yozgat Bozok Üniversitesi Tıp Fakültesi Biyokimya Anabilim Dalı, Yozgat, Türkiye)

Anestezi Dergisi

4 0

Yıl: 2023 Cilt: 31 Sayı: 1 Sayfa Aralığı: 85 - 92 Metin Dili: İngilizce DOI: 10.54875/jarss.2023.92063 İndeks Tarihi: 30-05-2023

Frailty Index is Associated with Vitamin D Insufficiency in Geriatric Surgery Patients: A Prospective Observational Study

Öz:

Objective: In this study, we aimed to investigate the relationship between vitamin D, frailty and postoperative outcomes in geriatric patients undergoing elective surgery. Methods: In this prospective observational study, a total of 90 el- derly patients who had undergone non-cardiac surgery were inc- luded. The patients were classified according to the frailty index (FI) score as “Non-frail (FI 0), Pre-frail (FI 1–2) and Frail (FI ≥3)”. In addition, patients were divided into two groups according to se- rum vitamin D concentration: vitamin D insufficiency group (n=41) and vitamin D sufficiency group (n=49). Clinical characteristics and postoperative outcomes of the patients were compared between the groups. Results: The mean age of the patients was 75.7 ± 7.6 years, the admission rate to Intensive Care Unit (ICU) was 43.3%, and the 30- day mortality rate after surgery was 21.1%. The ICU admission was significantly higher in the “vitamin D insufficiency” group (n=24 versus n=15, p=0.014). In addition, fragility status patients were significantly higher in the “vitamin D insufficiency” group (n=19 versus n=7, p=0.004). Most of the non-frail patients were in the “vitamin D sufficiency” group (n=18 versus n=9). Conclusion: In our study, we observed higher frailty in vitamin D insufficiency patients. In addition, admission to the postoperative ICU was higher in vitamin D insufficiency and frail patients. Our findings show that frailty and vitamin D insufficiency play an im- portant role in postoperative outcomes.

Anahtar Kelime:

Geriatrik Cerrahi Hastalarında Kırılganlık İndeksi D Vitamini Yetersizliği ile İlişkilidir: Prospektif Gözlemsel Çalışma

Öz:

Amaç: Bu çalışmada elektif cerrahi uygulanan geriatrik hastalarda D vitamini, kırılganlık ve postoperatif sonuçlar arasındaki ilişkiyi araştırmayı amaçladık. Yöntem: Bu prospektif gözlemsel çalışmaya, kalp dışı cerrahi geçir- miş toplam 90 yaşlı hasta dahil edildi. Hastalar kırılganlık indeksi (FI) skoruna göre “Kırılgan olmayan (FI 0), kırılganlık öncesi (FI 1–2) ve kırılgan (FI ≥3)” olarak sınıflandırıldı. Ayrıca hastalar serum D vitamini konsantrasyonuna göre “D vitamini yetersiz grup (n=41) ve D vitamini yeterli grup (n=49)” olmak üzere iki gruba ayrıldı. Hastaların klinik özellikleri ve postoperatif sonuçları gruplar ara- sında karşılaştırıldı. Bulgular: Hastaların ortalama yaşı 75,7 ± 7,6 yıl, yoğun bakım üni- tesine kabul oranı %43,3 ve ameliyat sonrası 30 günlük mortalite oranı %21,1 idi. “D vitamini yetersizliği” grubunda yoğun bakıma yatış anlamlı olarak daha yüksekti (n=24’e karşı n=15, p=0,014). Ayrıca kırılgan hastalar “D vitamini yetersizliği” grubunda anlamlı olarak daha yüksekti (n=19’a karşı n=7, p=0,004). Kırılgan olma- yan hastaların çoğu “D Vitamini yeterli” grubundaydı (n=18’e karşı n=9). Sonuç: Çalışmamızda D vitamini eksikliği olan hastalarda daha yüksek kırılganlık gözlemledik. Ayrıca D vitamini yetersizliği olan ve kırılgan hastalarda postoperatif yoğun bakıma yatış oranı daha yüksekti. Bulgularımız, postoperatif sonuçlarda kırılganlık ve D vi- tamini eksikliğinin önemli bir rol oynadığını göstermektedir.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık

1. Pelavski AD. Perioperative care of the elderly patient. Anesth Analg 2018;127(3):e40.
2. Toker KM, Altıparmak B, Uysal AI, Akarken I, Ugur B. The impact of preoperative frailty on postoperative complications in elderly patients undergoing urological malignancy surgery. Indian J Surg 2020;82(3):421-26.
3. Hewitt J, Long S, Carter B, Bach S, McCarthy K, Clegg A. The prevalence of frailty and its association with clinical outcomes in general surgery: A systematic review and meta-analysis. Age Ageing 2018;47(6):793-800.
4. Miniksar ÖH, Özdemir M. Clinical features and outcomes of very elderly patients admitted to the intensive care unit: A retrospective and observational study. Indian J Crit Care Med 2021;25(6):629-34.
5. Chan R, Ueno R, Afroz A, Billah B, Tiruvoipati R, Subramaniam A. Association between frailty and clinical outcomes in surgical patients admitted to intensive care units: A systematic review and meta-analysis. Br J Anaesth 2022;128:258-71.
6. Makary MA, Segev DL, Pronovost PJ, et al. Frailty as a predictor of surgical outcomes in older patients. J Am Coll Surg 2010;210(6):901-8.
7. Andreou A, Lasithiotakis K, Venianaki M. A comparison of two preoperative frailty models in predicting postoperative outcomes in geriatric general surgical patients. World J Surg 2018;42(12):3897-902.
8. Greene-Finestone L, Berger C, De Groh M, et al. 25-Hydroxyvi- tamin D in Canadian adults: Biological, environmental, and behavioral correlates. Osteoporos Int 2011;22(5):1389-99.
9. Feehan J, Phu S, Duque G. Vitamin D and Frailty. In: Musso CG, Jauregui JR, Macías-Núñez JF, Covic A, editors. Frailty and Kidney Disease. Switzerland: Springer, 2021;105.
10. Zhou J, Huang P, Liu P, et al. Association of vitamin D insufficiency and frailty: A systematic review and meta- analysis. Maturitas 2016;94:70-6.
11. Marcos-Pérez D, Sánchez-Flores M, Proietti S. Low vitamin d levels and frailty status in older adults: A systematic review and meta-analysis. Nutrients 2020;12(8):2286.
12. Phusunti S, Suthutvoravut W, Unnanuntana A, Chotiyarnwong P. The prevalence of hypovitaminosis D in patient with frailty hip fracture at a single institution in Thailand. J Med Assoc Thail 2016;99(11):1233–8.
13. Khan SA, Chua HW, Hirubalan P, Karthekeyan RB, Kothandan H. Association between frailty, cerebral oxygenation and adverse post-operative outcomes in elderly patients undergoing non-cardiac surgery: An observational pilot study. Indian J Anaesth 2016;60(2):102-7.
14. Puts MTE, Visser M, Twisk JWR, Deeg DJH, Lips P. Endocrine and inflammatory markers as predictors of frailty. Clin Endocrinol 2005;63(4):403-11.
15. Cigerli O, Parildar H, Unal AD, Tarcin O, Erdal R, Guvener Demirag N. Vitamin D insufficiency is a problem for adult out- patients? A university hospital sample in Istanbul, Turkey. Public Health Nutr 2013;16(7):1306-13.
16. Ganji V, Zhang X, Tangpricha V. Serum 25-Hydroxyvitamin D concentrations and prevalence estimates of hypovitaminosis D in the U.S. population based on assay-adjusted data. J Nutr 2012;142(3):498–507.
17. Soysal P, Stubbs B, Lucato P, et al. Inflammation and frailty in the elderly: A systematic review and meta-analysis. Ageing Res Rev 2016;31:1-8.
18. Ceglia L. Vitamin D and its role in skeletal muscle. Curr Opin Clin Nutr Metab Care 2009;12(6):628-33.
19. Kim J, Lee Y, Won CW, Kye S, Shim JS. Association of serum vitamin D with frailty in older Korean adults. Maturitas 2019;134:15-20.
20. Wong YYE, McCaul KA, Yeap BB, Hankey GJ, Flicker L. Low vitamin D status is an independent predictor of increased frailty and all-cause mortality in older men: The health in men study. J Clin Endocrinol Metab 2013;98(9):3821-8.
21. Buchebner D, Bartosch P, Malmgren L, McGuigan FE, Gerdhem P, Akesson KE. Association between vitamin D, frailty, and progression of frailty in community-dwelling older women. J Clin Endocrinol Metab 2019;104(12):6139-47.
22. Beggs T, Sepehri A, Szwajcer A, Tangri N, Arora RC. Frailty and perioperative outcomes: A narrative review. Can J Anesth 2015;62(2):143-57.
23. Turan A, Hesler BD, You J, et al. The association of serum vitamin D concentration with serious complications after noncardiac surgery. Anesth Analg 2014;119(3):603-12.
24. Xu HW, Shen B, Hu T, Zhao WD, Wu DS, Wang SJ. Preoperative vitamin D status and its effects on short-term clinical outcomes in lumbar spine surgery. J Orthop Sci 2020;25(5):787-92.

APA	Miniksar Ö, honca t, A, göçmen a (2023). Frailty Index is Associated with Vitamin D Insufficiency in Geriatric Surgery Patients: A Prospective Observational Study. , 85 - 92. 10.54875/jarss.2023.92063
Chicago	Miniksar Ökkeş Hakan,honca tevfik, AYŞEGÜL,göçmen ayşe yeşim Frailty Index is Associated with Vitamin D Insufficiency in Geriatric Surgery Patients: A Prospective Observational Study. (2023): 85 - 92. 10.54875/jarss.2023.92063
MLA	Miniksar Ökkeş Hakan,honca tevfik, AYŞEGÜL,göçmen ayşe yeşim Frailty Index is Associated with Vitamin D Insufficiency in Geriatric Surgery Patients: A Prospective Observational Study. , 2023, ss.85 - 92. 10.54875/jarss.2023.92063
AMA	Miniksar Ö,honca t, A,göçmen a Frailty Index is Associated with Vitamin D Insufficiency in Geriatric Surgery Patients: A Prospective Observational Study. . 2023; 85 - 92. 10.54875/jarss.2023.92063
Vancouver	Miniksar Ö,honca t, A,göçmen a Frailty Index is Associated with Vitamin D Insufficiency in Geriatric Surgery Patients: A Prospective Observational Study. . 2023; 85 - 92. 10.54875/jarss.2023.92063
IEEE	Miniksar Ö,honca t, A,göçmen a "Frailty Index is Associated with Vitamin D Insufficiency in Geriatric Surgery Patients: A Prospective Observational Study." , ss.85 - 92, 2023. 10.54875/jarss.2023.92063
ISNAD	Miniksar, Ökkeş Hakan vd. "Frailty Index is Associated with Vitamin D Insufficiency in Geriatric Surgery Patients: A Prospective Observational Study". (2023), 85-92. https://doi.org/10.54875/jarss.2023.92063

APA	Miniksar Ö, honca t, A, göçmen a (2023). Frailty Index is Associated with Vitamin D Insufficiency in Geriatric Surgery Patients: A Prospective Observational Study. Anestezi Dergisi, 31(1), 85 - 92. 10.54875/jarss.2023.92063
Chicago	Miniksar Ökkeş Hakan,honca tevfik, AYŞEGÜL,göçmen ayşe yeşim Frailty Index is Associated with Vitamin D Insufficiency in Geriatric Surgery Patients: A Prospective Observational Study. Anestezi Dergisi 31, no.1 (2023): 85 - 92. 10.54875/jarss.2023.92063
MLA	Miniksar Ökkeş Hakan,honca tevfik, AYŞEGÜL,göçmen ayşe yeşim Frailty Index is Associated with Vitamin D Insufficiency in Geriatric Surgery Patients: A Prospective Observational Study. Anestezi Dergisi, vol.31, no.1, 2023, ss.85 - 92. 10.54875/jarss.2023.92063
AMA	Miniksar Ö,honca t, A,göçmen a Frailty Index is Associated with Vitamin D Insufficiency in Geriatric Surgery Patients: A Prospective Observational Study. Anestezi Dergisi. 2023; 31(1): 85 - 92. 10.54875/jarss.2023.92063
Vancouver	Miniksar Ö,honca t, A,göçmen a Frailty Index is Associated with Vitamin D Insufficiency in Geriatric Surgery Patients: A Prospective Observational Study. Anestezi Dergisi. 2023; 31(1): 85 - 92. 10.54875/jarss.2023.92063
IEEE	Miniksar Ö,honca t, A,göçmen a "Frailty Index is Associated with Vitamin D Insufficiency in Geriatric Surgery Patients: A Prospective Observational Study." Anestezi Dergisi, 31, ss.85 - 92, 2023. 10.54875/jarss.2023.92063
ISNAD	Miniksar, Ökkeş Hakan vd. "Frailty Index is Associated with Vitamin D Insufficiency in Geriatric Surgery Patients: A Prospective Observational Study". Anestezi Dergisi 31/1 (2023), 85-92. https://doi.org/10.54875/jarss.2023.92063