THE EFFECT OF SPINAL ANESTHETIC TECHNIQUE ON NEUTROPHIL TO LYMPHOCYTE RATIO AND POSTOPERATIVE MORTALITY IN ELDERLY PATIENTS WITH CORONARY ARTERY DISEASE UNDERGOING HIP REPLACEMENT SURGERY

Karahan, Mahmut Alp

THE EFFECT OF SPINAL ANESTHETIC TECHNIQUE ON NEUTROPHIL TO LYMPHOCYTE RATIO AND POSTOPERATIVE MORTALITY IN ELDERLY PATIENTS WITH CORONARY ARTERY DISEASE UNDERGOING HIP REPLACEMENT SURGERY

Mahmut Alp KARAHAN (Harran Üniversitesi)

Türk Geriatri Dergisi

4 0

Yıl: 2019 Cilt: 22 Sayı: 3 Sayfa Aralığı: 305 - 314 Metin Dili: İngilizce İndeks Tarihi: 22-05-2020

THE EFFECT OF SPINAL ANESTHETIC TECHNIQUE ON NEUTROPHIL TO LYMPHOCYTE RATIO AND POSTOPERATIVE MORTALITY IN ELDERLY PATIENTS WITH CORONARY ARTERY DISEASE UNDERGOING HIP REPLACEMENT SURGERY

Öz:

Introduction: This study aimed to determine the effect of anesthetic techniques on the neutrophil-tolymphocyteratio in elderly patients with coronary artery disease who underwent hip replacement surgery.Materials and Method: In this retrospective cohort study, we reviewed the medical records of 41 elderlypatients with coronary artery disease who underwent hip replacement surgery between January 2015 andSeptember 2017. The following data were collected: demographic characteristics; neutrophil-to-lymphocyteratio measured preoperatively (T0; baseline), on postoperative day 1 (T1), and on postoperative day 2 (T2);anesthetic technique; surgery duration; postoperative complications; and postoperative 1-year mortality.Results: In total, 41 patients were included, of which 14 (34.1%) were men and 27 (65.9%) were women;the mean age was 77.8±7.89 (range, 65–95) years. The baseline neutrophil-to-lymphocyte ratio (T0) was6.22±3.8 increased to 10.66±11.47 on T1 and 8.75±7.81 on T2. neutrophil-to-lymphocyte ratio on T2 wassignificantly higher in patients receiving general anesthesia than in those receiving spinal anesthesia(p=0.032). Within 1 year after surgery, seven (30.6%) deaths were reported: one patient who received spinalepiduralanesthesia and 6 patients who received general anesthesia (p=0.044). The area under the curve forneutrophil-to-lymphocyte ratio on T2 was 0.79 (95% CI, 0.625–0.955; p=0.017) with an optimal cutoff valueof 5.18.Conclusion: Neutrophil-to-lymphocyte ratio on T2 is a risk factor for 1-year mortality in elderly patientswith coronary artery disease who underwent hip replacement surgery. Spinal anesthesia was observed tobe associated with a lower mortality rate by minimizing neutrophil-to-lymphocyte ratio value on T2 thangeneral anesthesia.

Anahtar Kelime:

Konular: Cerrahi

KALÇA PROTEZİ AMELİYATI GEÇİREN KORONER ARTER HASTALIĞINA SAHİP YAŞLI HASTALARDA SPİNAL ANESTEZİK TEKNİĞİN NÖTROFİL LENFOSİT ORANI VE POSTOPERATİF MORTALİTE ÜZERİNE ETKİSİ

Öz:

Giriş: Bu çalışmada, kalça protezi ameliyatı geçiren koroner arter hastalığına sahip yaşlı hastalarda anestezi tekniklerinin nötrofil-lenfosit oranı ve postoperatif mortalite üzerine etkisini belirlemek amaçlanmıştır. Gereç ve Yöntem: Retrospektif kohort çalışmamızda, Ocak 2015-Eylül 2017 tarihleri arasında kalça protezi ameliyatı geçirmiş koroner arter hastası olan geriatrik hastaların tıbbi kayıtlarını inceledik. Hastaların demografik özellikleri, uygulanan anestezik teknikleri; ameliyat süresi; ameliyat sonrası komplikasyonlar; ve postoperatif 1 yıllık mortalite ile ameliyat öncesi (T0; taban çizgisi), ameliyat sonrası 1. günde (T1) ve ameliyat sonrası 2. günde (T2) nötrofil-lenfosit oranı ölçüldü. Bulgular: 14’ü (% 34,1) erkek, 27’si (% 65,9) kadın; yaş ortalaması 77.8 ± 7.89 (dağılım, 65–95) olan toplamda 41’i hasta çalışmaya dahil edildi. Bazal nötrofil-lenfosit oranı (T0) 6.22 ± 3.8 idi, T1’de 10.66 ± 11.47’ye ve T2’de 8.75 ± 7.81’e yükseldi. Genel anestezi alan hastalarda T2’deki nötrofil-lenfosit oranı , spinal anestezi alanlara göre anlamlı derecede yüksekti (p = 0.032). Ameliyattan sonraki 1 yıllık mortaliteye bakıldığında, spinal-epidural anestezi alan bir hasta ve genel anestezi alan 6 hasta (p = 0.044) olmak üzere yedi (% 30.6) ölüm rapor edildi. T2’deki nötrofil-lenfosit oranı eğrisi altındaki alan 0.79 , optimum cut-off değeri ise 5.18 (% 95 CI, 0.625-0.955; p = 0.017) idi. Sonuç: T2’deki nötrofil-lenfosit oranı, kalça protezi ameliyatı geçiren koroner arter hastalığı olan yaşlı hastalarda 1 yıllık mortalite için risk faktörüdür. Spinal anestezinin, genel anesteziden ziyade T2’deki nötrofil / lenfosit oranını en aza indirerek düşük mortalite oranı ile ilişkili olduğu gözlendi.

Anahtar Kelime:

Konular: Cerrahi

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

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APA	Karahan M (2019). THE EFFECT OF SPINAL ANESTHETIC TECHNIQUE ON NEUTROPHIL TO LYMPHOCYTE RATIO AND POSTOPERATIVE MORTALITY IN ELDERLY PATIENTS WITH CORONARY ARTERY DISEASE UNDERGOING HIP REPLACEMENT SURGERY. , 305 - 314.
Chicago	Karahan Mahmut Alp THE EFFECT OF SPINAL ANESTHETIC TECHNIQUE ON NEUTROPHIL TO LYMPHOCYTE RATIO AND POSTOPERATIVE MORTALITY IN ELDERLY PATIENTS WITH CORONARY ARTERY DISEASE UNDERGOING HIP REPLACEMENT SURGERY. (2019): 305 - 314.
MLA	Karahan Mahmut Alp THE EFFECT OF SPINAL ANESTHETIC TECHNIQUE ON NEUTROPHIL TO LYMPHOCYTE RATIO AND POSTOPERATIVE MORTALITY IN ELDERLY PATIENTS WITH CORONARY ARTERY DISEASE UNDERGOING HIP REPLACEMENT SURGERY. , 2019, ss.305 - 314.
AMA	Karahan M THE EFFECT OF SPINAL ANESTHETIC TECHNIQUE ON NEUTROPHIL TO LYMPHOCYTE RATIO AND POSTOPERATIVE MORTALITY IN ELDERLY PATIENTS WITH CORONARY ARTERY DISEASE UNDERGOING HIP REPLACEMENT SURGERY. . 2019; 305 - 314.
Vancouver	Karahan M THE EFFECT OF SPINAL ANESTHETIC TECHNIQUE ON NEUTROPHIL TO LYMPHOCYTE RATIO AND POSTOPERATIVE MORTALITY IN ELDERLY PATIENTS WITH CORONARY ARTERY DISEASE UNDERGOING HIP REPLACEMENT SURGERY. . 2019; 305 - 314.
IEEE	Karahan M "THE EFFECT OF SPINAL ANESTHETIC TECHNIQUE ON NEUTROPHIL TO LYMPHOCYTE RATIO AND POSTOPERATIVE MORTALITY IN ELDERLY PATIENTS WITH CORONARY ARTERY DISEASE UNDERGOING HIP REPLACEMENT SURGERY." , ss.305 - 314, 2019.
ISNAD	Karahan, Mahmut Alp. "THE EFFECT OF SPINAL ANESTHETIC TECHNIQUE ON NEUTROPHIL TO LYMPHOCYTE RATIO AND POSTOPERATIVE MORTALITY IN ELDERLY PATIENTS WITH CORONARY ARTERY DISEASE UNDERGOING HIP REPLACEMENT SURGERY". (2019), 305-314.

APA	Karahan M (2019). THE EFFECT OF SPINAL ANESTHETIC TECHNIQUE ON NEUTROPHIL TO LYMPHOCYTE RATIO AND POSTOPERATIVE MORTALITY IN ELDERLY PATIENTS WITH CORONARY ARTERY DISEASE UNDERGOING HIP REPLACEMENT SURGERY. Türk Geriatri Dergisi, 22(3), 305 - 314.
Chicago	Karahan Mahmut Alp THE EFFECT OF SPINAL ANESTHETIC TECHNIQUE ON NEUTROPHIL TO LYMPHOCYTE RATIO AND POSTOPERATIVE MORTALITY IN ELDERLY PATIENTS WITH CORONARY ARTERY DISEASE UNDERGOING HIP REPLACEMENT SURGERY. Türk Geriatri Dergisi 22, no.3 (2019): 305 - 314.
MLA	Karahan Mahmut Alp THE EFFECT OF SPINAL ANESTHETIC TECHNIQUE ON NEUTROPHIL TO LYMPHOCYTE RATIO AND POSTOPERATIVE MORTALITY IN ELDERLY PATIENTS WITH CORONARY ARTERY DISEASE UNDERGOING HIP REPLACEMENT SURGERY. Türk Geriatri Dergisi, vol.22, no.3, 2019, ss.305 - 314.
AMA	Karahan M THE EFFECT OF SPINAL ANESTHETIC TECHNIQUE ON NEUTROPHIL TO LYMPHOCYTE RATIO AND POSTOPERATIVE MORTALITY IN ELDERLY PATIENTS WITH CORONARY ARTERY DISEASE UNDERGOING HIP REPLACEMENT SURGERY. Türk Geriatri Dergisi. 2019; 22(3): 305 - 314.
Vancouver	Karahan M THE EFFECT OF SPINAL ANESTHETIC TECHNIQUE ON NEUTROPHIL TO LYMPHOCYTE RATIO AND POSTOPERATIVE MORTALITY IN ELDERLY PATIENTS WITH CORONARY ARTERY DISEASE UNDERGOING HIP REPLACEMENT SURGERY. Türk Geriatri Dergisi. 2019; 22(3): 305 - 314.
IEEE	Karahan M "THE EFFECT OF SPINAL ANESTHETIC TECHNIQUE ON NEUTROPHIL TO LYMPHOCYTE RATIO AND POSTOPERATIVE MORTALITY IN ELDERLY PATIENTS WITH CORONARY ARTERY DISEASE UNDERGOING HIP REPLACEMENT SURGERY." Türk Geriatri Dergisi, 22, ss.305 - 314, 2019.
ISNAD	Karahan, Mahmut Alp. "THE EFFECT OF SPINAL ANESTHETIC TECHNIQUE ON NEUTROPHIL TO LYMPHOCYTE RATIO AND POSTOPERATIVE MORTALITY IN ELDERLY PATIENTS WITH CORONARY ARTERY DISEASE UNDERGOING HIP REPLACEMENT SURGERY". Türk Geriatri Dergisi 22/3 (2019), 305-314.