Purpose: Early mortality rate in geriatric patients after hip fractures remains very high. Determining the prognostic factors is crucial for decreasing early mortality. This study aimed to evaluate the prognostic risk factors affecting early mortality after hip fracture in the elderly.Methods: Medical records of 335 patients with age 70 years or older who sustained hip fractures which were treated by hemiarthroplasty or proximal femoral nailing between May 2017 and May 2019 were reviewed. Neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) were investigated for validity as the new prognostic markers. The other variables included age, gender, type of surgery, type of implant, type of anesthesia, American Society of Anesthesiologists (ASA) score, presence of comorbidities, delirium, length of hospital stay, time delay to surgery, number of erythrocyte transfusions, and laboratory data were assessed for 30-day, 90-day, and one-year mortality. Univariate analysis and logistic regression analysis were used to determine the associated mortality.Results: Thirty-day mortality rate was 10.4% and was associated with being aged ≥90 years (p-value: 0.013, odds ratio {OR}: 0.13) and ASA score of 4 (p-value: 0.019, OR: 0.22). Ninety-day mortality rate was 21.5% and was associated with age (p-value: 0.002), being aged 80-89 years (p-value: 0.032, OR: 0.43), being aged ≥90 years (p-value: 0.001, OR: 0.13), general anesthesia (p-value: 0.016, OR: 0.41), preoperative high NLR level (p-value: 0.028, OR: 1.05), high blood urea nitrogen (BUN) level (p-value: 0.049, OR:1.02). One year mortality rate was 33.7% and independent significant prognostic risk factors were determined as being aged ≥90 years (p-value: 0.003, OR: 0.23), length of hospital stay (p-value: 0.003, OR: 1.04), and preoperative serum albumin level (p-value: 0.037, OR: 0.6). The other evaluated risk factors were not independently found to be associated with all early mortality time.Conclusion: Patients at or over 90 years old were at risk for all early mortality time points. NLR which is a new and cheap biomarker can be used as a prognostic risk factor for 90-day mortality. The variable of PLR was not found valuable for early mortality.

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Objective: Therapeutic use of thermal agents such as hot-cold is common in clinical practice and rehabilitation applications. Changes in tissue temperature create a therapeutic effect by making alterations in metabolism, neurotransmission, hemodynamics and mechanical properties. In this study, the effects of hot-cold applications on patellar tendon to torque-time parameters were investigated. Materials and Methods: 30 healthy individuals (16 males, 14 females) at the age of 18-30 years were participated to the study. Participants' demographic characteristics were recorded, body weight and height measurements were performed, and Tegner activity scores were noted. Hot and cold applications have been applied to the participants with 48 hours of interval. Following 5 minutes of submaximal warming exercise in cycle ergometer, patellar tendon temperatures were measured with infrared thermometer and thermal camera. Isokinetic strength tests (concentric mode at 60°/second and 180°/second) were performed. Hot or cold applications were performed on patellar tendon for 30 minutes. The submaximal warmup exercise repeated following the application, temperature measurements and isokinetic tests were performed again. All tests were performed on dominant lower extremity of the participants. Results: Statistically significant results were obtained both at infrared thermometer (p<0.001) and also at thermal camera measurements (p<0.001) in the pre-post cooling and heating temperature evaluations. Time to peak torque and rate of peak torque development were similar in pre and post cold measurements (p >0.05), whereas time to peak torque was significantly lower (p<0.05) and significant increase in rate of peak torque development (p<0.01) has been determined following hot application. Conclusion: Heat application on patellar tendon may improve athletic performances that require explosive force. There is need for more comprehensive studies to validate the findings obtained by this study.

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