Hip Fracture Surgery in Patients Older than 90 Years: Evaluation of Factors that Affect 30-Day Mortality in a Particularly Risky Group

Daşar, Uygar

doi:10.31086/tjgeri.2018240429

Cited by 3 publications

(4 citation statements)

References 42 publications

(27 reference statements)

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“…Various patient-related factors have been reported to be correlated with mortality in the postoperative first year, including advanced age, high preoperative ASA score, obesity, comorbid diseases and postoperative intensive care requirement. [18][19][20][21][22][23] In parallel with the literature, the findings of our study suggested that having two or more comorbidities was a risk factor for mortality in the first year postoperative. On the other hand, no significant correlation was established be- tween age, preoperative ASA score, postoperative intensive care requirement, obesity and duration of hospitalization and mortality in our study.…”

Section: Discussionsupporting

confidence: 72%

Is The Preoperative Neutrophil-To-Lymphocyte Ratio A Predictive Value For Postoperative Mortality In Orthogeriatric Patients Who Underwent Proximal Femoral Nail Surgery For Pertrochanteric Fractures?

Özbek¹

2020

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Hip fractures in the orthogeriatric population are a health problem that causes mortality and morbidity, with an increasing frequency. The present study aims to investigate whether the preoperative neutrophil-to-lymphocyte ratio (NLR) is a predictive value for the postoperative mortality risk in patients who underwent only proximal femoral nail (PFN) surgery due to pertrochanteric fractures (PTF). To our knowledge, there is not any study conducted with a similar population in the litertaure. METHODS:Fifty-five patients who were operated on by two National Board-certified surgeons with the PFN method were included in our retrospective study. The patients were divided into two groups. Group A included the patients who lost their lives within the postoperative first year (n=13), while Group B included the survivors (n=42). Preoperative NLR data, demographic information, duration of hospitalization, postoperative intensive care requirements (ICU) and comorbid diseases of all patients were recorded. RESULTS:In our study with a maximum follow-up period of 27 months, no statistically significant difference was found between the groups concerning age, gender, body mass index, preoperative American Society of Anesthesiologists scores (ASA), types of fractures, ICU requirements, duration of hospitalization (p>0.05). However, the NLR was significantly higher in Group A (p<0.01), with a cut-off value of 5.25, sensitivity of 84.6% and specificity of 78.6%. CONCLUSION:We believe that the preoperative NLR is a predictive variable for orthopedic surgeons in assessing the postoperative mortality risk in orthogeriatric patients who presented to the emergency room due to PTF and were planned to undergo PFN surgery.

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Section: Discussionsupporting

confidence: 72%

Is The Preoperative Neutrophil-To-Lymphocyte Ratio A Predictive Value For Postoperative Mortality In Orthogeriatric Patients Who Underwent Proximal Femoral Nail Surgery For Pertrochanteric Fractures?

Özbek¹

2020

Ulus Travma Acil Cerrahi Derg

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“…Hip fractures have been considered as one of the most important causes of mortality and increased hospitalization associated with the discipline of orthopedics and traumatology in the elderly (1,2,14) .…”

Section: Discussionmentioning

confidence: 99%

“…Hip fractures are among the most important causes of death associated with orthopedics and traumatology in the elderly (1,2) . The hip fractures have become more common worldwide due to aging of the population (3) .…”

Section: Introductionmentioning

confidence: 99%

“…Different factors such as age, gender, comorbidity, time to surgery, and treatment type have been shown to affect mortality rates in patients with hip fractures (5,6) . However, there is no consensus on the systemic factors affecting hip fracture mortality (1) . According to some studies, femoral neck fracture have lower mortality risk than pertrochanteric hip fractures.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation Of The Major Predictors Of Long-Term Mortality In Patients Who Underwent Hemiarthroplasty For Hip Fracture

Özcan¹,

Genç²

2020

IKSST

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Objective: The aim of this study was to determine long-term mortality and related predictors in patients who underwent hemiarthroplasty. Method: In this study, clinical data of 282 patients were evaluated. Patients with a pathologic fracture, incomplete medical data, and those who died postoperatively before being discharge were excluded from the study. Patient characteristics related to age, gender, fracture type, comorbidities (0-2, 3+), time until surgery, American Society of Anesthesiologists (ASA) score, anesthesia type, duration of surgery, postoperative intensive care unit (ICU) stay, postoperative hospital stay and mortality within the 3 years after discharge were examined. The mean survival rates were obtained with the Kaplan-Meier method. In addition, Cox regression method was used to analyze the factors that were effective on the mortality. Results: Two hundred and sixty-three patients were included in our study. The median follow-up period was 32 months (range 0-86). The mortality rate was 56% at 3 years after discharge. The mean age of surviving patients in the third year was significantly lower (p<0.001). Frequency of having 3 or more comorbidities and ICU stay were higher in the nonsurvivor group (p<0.001 and p=0.007, respectively). ASA score were ≥3 in 104 (71%) of the 147 patients who did not survive, whereas it was ≥3 in 69 (59%) of the 116 patients from the surviving group (P =0.056). Conclusion: In our study, age, presence of ≥3 comorbidity, time until surgery and anesthesia type were detected as risk factors for mortality.

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Can the Neutrophil-to-Platelet Ratio Be Used to Predict Postoperative Mortality in Geriatric Patients with Hip Fractures?

SEZER AKMAN,

SELÇUK KUŞDERCİ,

KEHRİBAR

et al. 2023

Hitit Medical Journal

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Objective: Hip fracture is a condition frequently encountered in geriatric patients and is correlated with high postoperative mortality and morbidity.Numerous factors may impact mortality, but recent studies have focused on its correlation with inflammation. The neutrophil-to-platelet ratio has been evaluated as a systemic inflammation marker.The aim of our study was to examine the correlation between preoperative neutrophil-to-platelet ratio (NPR) values and postoperative one-year mortality in geriatric patients with hip fractures. Materials and Methods: In our retrospective, multicenter study, 50 patients over 65 years of age who had undergone hip fracture surgery under spinal anesthesia were examined. Patients’ preoperative neutrophil-to-platelet ratio values at the time of hospitalization, age, gender, American Society of Anesthesiologists scores, fracture types, comorbidities, durations of surgery, lengths of hospital stay, and survival in the postoperative one-year period were checked. Results: The mean age of all the patients was 85.44 ± 6.93 years.Of the patients, 60% were female (n = 30), and 40% were male (n = 20).The optimal cut-off value for preoperative neutrophil-to-platelet ratio was specified as 38.286. The length of hospital stay was 8.94 ± 3.05 in the deceased patients and 6.94 ± 2.63 days (p = 0.02) in the surviving group. The mortality rate was higher in men than in women (p = 0.01). Conclusion: A preoperative neutrophil-to-platelet ratio value over 38.286 is an indicator of postoperative one-year mortality in elderly hip fracture patients. Additionally, length of hospital stay and the male gender were revealed to be correlated with mortality.

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Hip Fracture Surgery in Patients Older than 90 Years: Evaluation of Factors that Affect 30-Day Mortality in a Particularly Risky Group

Cited by 3 publications

References 42 publications

Is The Preoperative Neutrophil-To-Lymphocyte Ratio A Predictive Value For Postoperative Mortality In Orthogeriatric Patients Who Underwent Proximal Femoral Nail Surgery For Pertrochanteric Fractures?

Is The Preoperative Neutrophil-To-Lymphocyte Ratio A Predictive Value For Postoperative Mortality In Orthogeriatric Patients Who Underwent Proximal Femoral Nail Surgery For Pertrochanteric Fractures?

Evaluation Of The Major Predictors Of Long-Term Mortality In Patients Who Underwent Hemiarthroplasty For Hip Fracture

Can the Neutrophil-to-Platelet Ratio Be Used to Predict Postoperative Mortality in Geriatric Patients with Hip Fractures?

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