Yıl: 2018 Cilt: 27 Sayı: 3 Sayfa Aralığı: 111 - 116 Metin Dili: İngilizce DOI: 10.9739/tjvs.2018.198 İndeks Tarihi: 25-04-2019

Surgical results of acute thromboembolic limb ischemia in octogenarians

Öz:
Objectives: The aim of this study was to evaluate surgical outcomes of octogenarian patients presenting with acute limb ischemia (ALI) andundergoing urgent thromboembolectomy.Patients and methods: Between January 2016 and March 2018, the medical charts of a total of 27 octogenarian patients (16 females, 11 males;median age 85.2±4.3 years; range, 80 to 95 years) who were diagnosed with acute thromboembolic ischemia of the lower or upper limb and underwenturgent thromboembolectomy at our institution were retrospectively analyzed. The 30-day mortality rate of ALI was evaluated. Demographic andclinical characteristics of the patients, associated pathologies, and postoperative outcomes including infection, gastrointestinal bleeding, hematoma,revision surgery, and amputation were recorded.Results: Nineteen patients (70.3%) had acute lower limb ischemia, while eight patients (29.7%) had acute upper limb ischemia. Acute ischemicpain was the most commonly seen symptom (n=26, 96.3%). Atrial fibrillation was the most common comorbidity in 62.9% patients. Postoperativecomplications included hematoma (n=5, 18.5%), wound infection (n=4, 14.8%), and gastrointestinal bleeding (n=2, 7.4%). Re-embolectomy wasperformed in three patients (11.1%). Fasciotomies were performed during follow-up due to compartment syndrome in three patients (11.1%) andthese patients subsequently underwent lower limb amputation. The 30-day mortality occurred in two patients due to renal failure and the mortalityrate was found to be 7.4%.Conclusion: Based on our study results, ALI in octogenarians has different outcomes. Our findings suggest that patients with neurological deficit due to delayed ischemia and those with diabetes mellitus and severe ischemia face a higher risk in mortality and morbidity
Anahtar Kelime:

Konular: Cerrahi

Seksen yaş ve üzeri hastalarda akut tromboembolik ekstremite iskemisinin cerrahi sonuçları

Öz:
Amaç: Bu çalışmada, akut ekstremite iskemisi (AEİ) olan ve acil tromboembolektomi yapılan seksen yaş ve üzeri hastaların cerrahi sonuçları değerlendirildi. Hastalar ve Yöntemler: Ocak 2016 - Mart 2018 tarihleri arasında hastanemizde alt veya üst ekstremitede akut tromboembolik iskemi tanısı konan ve acil tromboembolektomi yapılan 80 yaş ve üzeri toplam 27 hastanın (16 kadın, 11 erkek; medyan yaş 85.2±4.3 yıl; dağılım, 80-95 yıl) tıbbi dosyası retrospektif olarak incelendi. Akut ekstremite iskemisinin 30 günlük mortalite oranı değerlendirildi. Hastaların demografik ve klinik özellikleri, eşlik eden hastalıkları ve enfeksiyon, gastrointestinal kanama, hematom, revizyon cerrahisi ve ampütasyon dahil olmak üzere ameliyat sonrası sonuçlar kaydedildi. Bulgular: On dokuz hastada (%70.3) akut alt ekstremite iskemisi var iken, sekiz hastada (%29.7) akut üst ekstremite iskemisi vardı. Akut iskemiye bağlı akut ağrı, en sık görülen semptomdu (n=26, %96.3). Atriyal fibrilasyon, hastaların %62.9’unda en sık görülen komorbidite idi. Ameliyat sonrası komplikasyonlar hematom (n=5, %18.5), yara yeri enfeksiyonu (n=4, %14.8) ve gastrointestinal kanama (n=2, %7.4) idi. Üç hastada (%11.1) embolektomi yeniden yapıldı. Üç hastaya (%11.1) kompartman sendromu nedeniyle fasyotomi uygulandı ve bu hastalara akabinde alt ekstremite ampütasyonu yapıldı. İki hastada böbrek yetmezliğine bağlı mortalite izlendi ve mortalite oranı %7.4 olarak bulundu. Sonuç: Çalışma sonuçlarımıza göre, ALI seksen yaş ve üzeri hastalarda farklı sonuçlar doğurmaktadır. Çalışma bulgularımız uzamış iskemi nedeniyle nörolojik defisit gelişen hastalar ve diabetes mellitus ve şiddetli iskemili hastaların mortalite ve morbidite açısından daha yüksek bir risk ile karşı karşıya olduğunu göstermektedir.
Anahtar Kelime:

Konular: Cerrahi
Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA Aldag M, Oztekin A, Bademci M, Kocaaslan C, DENLİ YALVAÇ E, Aydin E (2018). Surgical results of acute thromboembolic limb ischemia in octogenarians. , 111 - 116. 10.9739/tjvs.2018.198
Chicago Aldag Mustafa,Oztekin Ahmet,Bademci Mehmet Senel,Kocaaslan Cemal,DENLİ YALVAÇ Emine Şeyma,Aydin Ebuzer Surgical results of acute thromboembolic limb ischemia in octogenarians. (2018): 111 - 116. 10.9739/tjvs.2018.198
MLA Aldag Mustafa,Oztekin Ahmet,Bademci Mehmet Senel,Kocaaslan Cemal,DENLİ YALVAÇ Emine Şeyma,Aydin Ebuzer Surgical results of acute thromboembolic limb ischemia in octogenarians. , 2018, ss.111 - 116. 10.9739/tjvs.2018.198
AMA Aldag M,Oztekin A,Bademci M,Kocaaslan C,DENLİ YALVAÇ E,Aydin E Surgical results of acute thromboembolic limb ischemia in octogenarians. . 2018; 111 - 116. 10.9739/tjvs.2018.198
Vancouver Aldag M,Oztekin A,Bademci M,Kocaaslan C,DENLİ YALVAÇ E,Aydin E Surgical results of acute thromboembolic limb ischemia in octogenarians. . 2018; 111 - 116. 10.9739/tjvs.2018.198
IEEE Aldag M,Oztekin A,Bademci M,Kocaaslan C,DENLİ YALVAÇ E,Aydin E "Surgical results of acute thromboembolic limb ischemia in octogenarians." , ss.111 - 116, 2018. 10.9739/tjvs.2018.198
ISNAD Aldag, Mustafa vd. "Surgical results of acute thromboembolic limb ischemia in octogenarians". (2018), 111-116. https://doi.org/10.9739/tjvs.2018.198
APA Aldag M, Oztekin A, Bademci M, Kocaaslan C, DENLİ YALVAÇ E, Aydin E (2018). Surgical results of acute thromboembolic limb ischemia in octogenarians. Damar Cerrahi Dergisi, 27(3), 111 - 116. 10.9739/tjvs.2018.198
Chicago Aldag Mustafa,Oztekin Ahmet,Bademci Mehmet Senel,Kocaaslan Cemal,DENLİ YALVAÇ Emine Şeyma,Aydin Ebuzer Surgical results of acute thromboembolic limb ischemia in octogenarians. Damar Cerrahi Dergisi 27, no.3 (2018): 111 - 116. 10.9739/tjvs.2018.198
MLA Aldag Mustafa,Oztekin Ahmet,Bademci Mehmet Senel,Kocaaslan Cemal,DENLİ YALVAÇ Emine Şeyma,Aydin Ebuzer Surgical results of acute thromboembolic limb ischemia in octogenarians. Damar Cerrahi Dergisi, vol.27, no.3, 2018, ss.111 - 116. 10.9739/tjvs.2018.198
AMA Aldag M,Oztekin A,Bademci M,Kocaaslan C,DENLİ YALVAÇ E,Aydin E Surgical results of acute thromboembolic limb ischemia in octogenarians. Damar Cerrahi Dergisi. 2018; 27(3): 111 - 116. 10.9739/tjvs.2018.198
Vancouver Aldag M,Oztekin A,Bademci M,Kocaaslan C,DENLİ YALVAÇ E,Aydin E Surgical results of acute thromboembolic limb ischemia in octogenarians. Damar Cerrahi Dergisi. 2018; 27(3): 111 - 116. 10.9739/tjvs.2018.198
IEEE Aldag M,Oztekin A,Bademci M,Kocaaslan C,DENLİ YALVAÇ E,Aydin E "Surgical results of acute thromboembolic limb ischemia in octogenarians." Damar Cerrahi Dergisi, 27, ss.111 - 116, 2018. 10.9739/tjvs.2018.198
ISNAD Aldag, Mustafa vd. "Surgical results of acute thromboembolic limb ischemia in octogenarians". Damar Cerrahi Dergisi 27/3 (2018), 111-116. https://doi.org/10.9739/tjvs.2018.198