Factors affecting postoperative mortality in patients older than 65 years undergoing surgery for hip fracture

ÖZKAZANLI, Gökhan; ORAK, Mehmet Müfit; SAYGI, BARANSEL; Karakus, Ozgun; Mutlu, Harun; Çalışkan, Gürkan; MUTLU, Serhat; KARAMAN, Özgür

Factors affecting postoperative mortality in patients older than 65 years undergoing surgery for hip fracture

Özgür KARAMAN, (Fatih Sultan Mehmet Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Kliniği, İstanbul, Türkiye)

Gökhan ÖZKAZANLI, (Fatih Sultan Mehmet Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Kliniği, İstanbul, Türkiye)

Mehmet Müfit ORAK, (Fatih Sultan Mehmet Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Kliniği, İstanbul, Türkiye)

Serhat MUTLU, (Kanuni Sultan Süleyman Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatolji Kliniği, İstanbul, Türkiye)

Harun MUTLU, (Gaziosmanpaşa Taksim Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Kliniği, İstanbul, Türkiye)

Gürkan ÇALIŞKAN, (Kanuni Sultan Süleyman Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatolji Kliniği, İstanbul, Türkiye)

Özgün KARAKUŞ, (Fatih Sultan Mehmet Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Kliniği, İstanbul, Türkiye)

Baransel SAYGI (Fatih Sultan Mehmet Eğitim ve Araştırma Hastanesi, Ortopedi ve Travmatoloji Kliniği, İstanbul, Türkiye)

Ulusal Travma ve Acil Cerrahi Dergisi

11 0

Yıl: 2015 Cilt: 21 Sayı: 1 Sayfa Aralığı: 44 - 50 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Factors affecting postoperative mortality in patients older than 65 years undergoing surgery for hip fracture

Öz:

AMAÇ: Çalışmamızdaki amaç 65 yaş üstü kalça kırığı nedeni ile ameliyat olan kalça kırığına etki eden mortalite faktörlerinin belirlenmesidir. GEREÇ VE YÖNTEM: Altmış beş yaş üstü 219 erkek, 89 kadın toplam 308 hasta dahil edildi. Anestezi tipi olarak 203 hastaya spinal/epidural ve 105 hastaya genel anestezi verildi. Hastaların ASA değerlendirilmesinde ASA 1-2 ve ASA 3-4 olarak iki grup belirlendi. Ameliyat öncesinde hastaların mevcut olan sistemik hastalıkları belirlendi. BULGULAR: Toplam 308 hastanın 77'si (%25) öldü. Ayrıca ameliyat öncesinde olarak kardiyak hastalığı olan hastalar, genel anestezi yapılan hastalar, ASA3-4 grubu olan hastalar ve yaş mortalite için anlamlı yüksek bulundu. Bu dört etkili faktöre lojistik regresyon analizi yapıldığında ise yaş, genel anestezi, kardiyak hastalığın varlığı mortalite üzerinde etkilidir. Ancak ASA skoru yaşa ve kardiyak hastalığa bağımlı olarak değişmektedir. TARTIŞMA: Çoklu risk faktörlerinin bulunduğu durumlarda hangi faktörün gerçekte daha etkili olduğunu hesaplamak gerekli. Yaş, ASA skoru, anastezi şekli ve kardiyak hastalık varlığı mortaliteyi etkilemektedir. Ancak ASA skoru kardiyak hastalık ve yaş faktörüne bağımlı olarak mortaliteyi etkilemektedir

Anahtar Kelime:

Konular: Cerrahi

Kalça kırığı nedeni ile ameliyat edilen 65 yaş üstü hastalarda mortaliteye etki eden faktörler

Öz:

BACKGROUND: The aim of this study was to determine the factors affecting postoperative mortality in patients older than 65 years of age undergoing surgery for hip fracture.METHODS: A total of 308 patients (219 males and 89 females) were included into the study. Spinal-epidural anaesthesia was administered in 203 patients and general anaesthesia in 105 patients. In the evaluation of the patients regarding ASA, two groups were determined ASA 1-2 and ASA 3-4. Systemic diseases present in the patients were determined preoperatively.RESULTS: Seventy-seven (25%) of the total 308 patients died. In addition, patients with preoperative cardiac disease, patients on whom general anaesthesia was administered, patients in the ASA 3-4 group, and age were found to be significantly higher in mortality. When logistic regression analysis was performed for these four efficient factors, age, general anaesthesia, presence of cardiac disease were effective in mortality. However, ASA score changed depending on the age and cardiac disease.CONCLUSION: In case of presence of multiple risk factors, it is necessary to determine which factor is, in fact, more effective. Age, ASA score, type of anaesthesia, and presence of cardiac disease are effective in mortality. However, ASA score affects mortality depending on the cardiac disease and age

Anahtar Kelime:

Konular: Cerrahi

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

Cooper C, Campion G, Melton LJ 3rd. Hip fractures in the elderly: a world-wide projection. Osteoporos Int 1992;2:285-9.
Beaupre LA, Jones CA, Saunders LD, Johnston DW, Buckingham J, Ma- jumdar SR. Best practices for elderly hip fracture patients. A systematic overview of the evidence. J Gen Intern Med 2005;20:1019-25.
Wilkins K. Health care consequences of falls for seniors. Health Rep 1999;10:47-55.
Magaziner J, Lydick E, Hawkes W, Fox KM, Zimmerman SI, Epstein RS, et al. Excess mortality attributable to hip fracture in white women aged 70 years and older. Am J Public Health 1997;87:1630-6.
Schrİder HM, Erlandsen M. Age and sex as determinants of mortality after hip fracture: 3,895 patients followed for 2.5-18.5 years. J Orthop Trauma 1993;7:525-31.
Vestergaard P, Rejnmark L, Mosekilde L. Has mortality after a hip frac- ture increased? J Am Geriatr Soc 2007;55:1720-6.
Richmond J, Aharonoff GB, Zuckerman JD, Koval KJ. Mortality risk af- ter hip fracture. 2003. J Orthop Trauma 2003;17(8 Suppl):S2-5.
Donegan DJ, Gay AN, Baldwin K, Morales EE, Esterhai JL Jr, Mehta S. Use of medical comorbidities to predict complications after hip fracture surgery in the elderly. J Bone Joint Surg Am 2010;92:807-13.
Saklad M. Grading of patients for surgical procedures. Anesthesiology 1941;2:281-4.
Aharonoff GB, Koval KJ, Skovron ML, Zuckerman JD. Hip frac- tures in the elderly: predictors of one year mortality. J Orthop Trauma 1997;11:162-5.
Cipitria JA, Sosa MM, Pezzotto SM, Puche RC, Bocanera R. Outcome of hip fractures among elderly subjects. Medicina (B Aires) 1997;57:530- 4.
Kenzora JE, McCarthy RE, Lowell JD, Sledge CB. Hip fracture mortal- ity. Relation to age, treatment, preoperative illness, time of surgery, and complications. Clin Orthop Relat Res 1984;186:45-56.
Rodgers A, Walker N, Schug S, McKee A, Kehlet H, van Zundert A, et al. Reduction of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised trials. BMJ 2000;321:1493.
Mahoney FI, Barthel DW. Functional evaluation: the Barthel Index. Md State Med J 1965;14:61-5.
Ozkaya U, Parmaksizoğlu AS, Gül M, Kabukçuoğlu Y, Ozkazanli G, Basilgan S. Management of osteoporotic pertrochanteric fractures with external fixation in elderly patients. Acta Orthop Traumatol Turc 2008;42:246-51.
Farahmand BY, Michaëlsson K, Ahlbom A, Ljunghall S, Baron JA; Swed- ish Hip Fracture Study Group. Survival after hip fracture. Osteoporos Int 2005;16:1583-90.
Vestergaard P, Rejnmark L, Mosekilde L. Has mortality after a hip frac- ture increased? J Am Geriatr Soc 2007;55:1720-6.
White BL, Fisher WD, Laurin CA. Rate of mortality for elderly pa- tients after fracture of the hip in the 1980's. J Bone Joint Surg Am 1987;69:1335-40.
Parker MJ, Pryor GA. Internal fixation or arthroplasty for displaced cer- vical hip fractures in the elderly: a randomised controlled trial of 208 pa- tients. Acta Orthop Scand 2000;71:440-6.
Bhandari M, Devereaux PJ, Swiontkowski MF, Tornetta P 3rd, Obrem- skey W, Koval KJ, et al. Internal fixation compared with arthroplasty for displaced fractures of the femoral neck. A meta-analysis. J Bone Joint Surg Am 2003;85-A:1673-81.
Keene GS, Parker MJ, Pryor GA. Mortality and morbidity after hip frac- tures. BMJ 1993;307:1248-50.
Kesmezacar H, Ayhan E, Unlu MC, Seker A, Karaca S. Predictors of mortality in elderly patients with an intertrochanteric or a femoral neck fracture. J Trauma 2010;68:153-8.
Zuckerman JD. Hip fracture. N Engl J Med 1996;334:1519-25.
Fleisher LA. Risk of anesthesia. In: Miller RD, editor. Miller's anesthesia. Vol 1, 6th ed. USA: Elsevier; 2005. p. 893-925.

APA	KARAMAN Ö, ÖZKAZANLI G, ORAK M, MUTLU S, Mutlu H, Çalışkan G, Karakus O, SAYGI B (2015). Factors affecting postoperative mortality in patients older than 65 years undergoing surgery for hip fracture. , 44 - 50.
Chicago	KARAMAN Özgür,ÖZKAZANLI Gökhan,ORAK Mehmet Müfit,MUTLU Serhat,Mutlu Harun,Çalışkan Gürkan,Karakus Ozgun,SAYGI BARANSEL Factors affecting postoperative mortality in patients older than 65 years undergoing surgery for hip fracture. (2015): 44 - 50.
MLA	KARAMAN Özgür,ÖZKAZANLI Gökhan,ORAK Mehmet Müfit,MUTLU Serhat,Mutlu Harun,Çalışkan Gürkan,Karakus Ozgun,SAYGI BARANSEL Factors affecting postoperative mortality in patients older than 65 years undergoing surgery for hip fracture. , 2015, ss.44 - 50.
AMA	KARAMAN Ö,ÖZKAZANLI G,ORAK M,MUTLU S,Mutlu H,Çalışkan G,Karakus O,SAYGI B Factors affecting postoperative mortality in patients older than 65 years undergoing surgery for hip fracture. . 2015; 44 - 50.
Vancouver	KARAMAN Ö,ÖZKAZANLI G,ORAK M,MUTLU S,Mutlu H,Çalışkan G,Karakus O,SAYGI B Factors affecting postoperative mortality in patients older than 65 years undergoing surgery for hip fracture. . 2015; 44 - 50.
IEEE	KARAMAN Ö,ÖZKAZANLI G,ORAK M,MUTLU S,Mutlu H,Çalışkan G,Karakus O,SAYGI B "Factors affecting postoperative mortality in patients older than 65 years undergoing surgery for hip fracture." , ss.44 - 50, 2015.
ISNAD	KARAMAN, Özgür vd. "Factors affecting postoperative mortality in patients older than 65 years undergoing surgery for hip fracture". (2015), 44-50.

APA	KARAMAN Ö, ÖZKAZANLI G, ORAK M, MUTLU S, Mutlu H, Çalışkan G, Karakus O, SAYGI B (2015). Factors affecting postoperative mortality in patients older than 65 years undergoing surgery for hip fracture. Ulusal Travma ve Acil Cerrahi Dergisi, 21(1), 44 - 50.
Chicago	KARAMAN Özgür,ÖZKAZANLI Gökhan,ORAK Mehmet Müfit,MUTLU Serhat,Mutlu Harun,Çalışkan Gürkan,Karakus Ozgun,SAYGI BARANSEL Factors affecting postoperative mortality in patients older than 65 years undergoing surgery for hip fracture. Ulusal Travma ve Acil Cerrahi Dergisi 21, no.1 (2015): 44 - 50.
MLA	KARAMAN Özgür,ÖZKAZANLI Gökhan,ORAK Mehmet Müfit,MUTLU Serhat,Mutlu Harun,Çalışkan Gürkan,Karakus Ozgun,SAYGI BARANSEL Factors affecting postoperative mortality in patients older than 65 years undergoing surgery for hip fracture. Ulusal Travma ve Acil Cerrahi Dergisi, vol.21, no.1, 2015, ss.44 - 50.
AMA	KARAMAN Ö,ÖZKAZANLI G,ORAK M,MUTLU S,Mutlu H,Çalışkan G,Karakus O,SAYGI B Factors affecting postoperative mortality in patients older than 65 years undergoing surgery for hip fracture. Ulusal Travma ve Acil Cerrahi Dergisi. 2015; 21(1): 44 - 50.
Vancouver	KARAMAN Ö,ÖZKAZANLI G,ORAK M,MUTLU S,Mutlu H,Çalışkan G,Karakus O,SAYGI B Factors affecting postoperative mortality in patients older than 65 years undergoing surgery for hip fracture. Ulusal Travma ve Acil Cerrahi Dergisi. 2015; 21(1): 44 - 50.
IEEE	KARAMAN Ö,ÖZKAZANLI G,ORAK M,MUTLU S,Mutlu H,Çalışkan G,Karakus O,SAYGI B "Factors affecting postoperative mortality in patients older than 65 years undergoing surgery for hip fracture." Ulusal Travma ve Acil Cerrahi Dergisi, 21, ss.44 - 50, 2015.
ISNAD	KARAMAN, Özgür vd. "Factors affecting postoperative mortality in patients older than 65 years undergoing surgery for hip fracture". Ulusal Travma ve Acil Cerrahi Dergisi 21/1 (2015), 44-50.