ÖZET

Amaç:

Kalça kırıkları geriatrik hasta grubunda önemli bir sağlık sorunudur. Malnütrisyonun saptanması, perioperatif tedavi planının oluşturulması, prognozun belirlenmesi ve böylece morbidite ve mortalitenin azaltılması açısından önemlidir. Prognostik beslenme indeksi (Prognostic nutritional index, PNI), hastaların beslenme durumunun bir göstergesi olan basit, uygun maliyetli ve kolay uygulanabilir bir parametredir. Bu çalışmanın amacı, postoperatif kalça kırığı hastalarında preoperatif PNI ile mortalite arasındaki ilişkiyi incelemektir.

Gereç ve Yöntem:

Bu prospektif gözlemsel çalışmaya, kalça kırığı sonrası ilk 48 saat içinde ameliyat edilen, Amerikan Anesteziyoloji Derneği skoru I-IV arası olan, 65-95 yaş arası 183 hasta dahil edildi. Hastalar PNI’nın 37,25 eşik değerine göre 2 gruba ayrıldı. Toplamda 172 hasta çalışmayı tamamladı: 53’ü grup düşük PNI’da ve 119’u grup yüksek PNI’da sınıflandı.

Bulgular:

Hastanede kalış süresi grup düşük PNI’da anlamlı olarak daha yüksekti (p=0,035). Postoperatif deliryum grup düşük PNI’da anlamlı olarak daha yüksek bulundu (p=0,001). Üç aylık mortalite grup düşük PNI’da anlamlı olarak daha yüksekti (p=0,0001).

Sonuç:

Rutin taramalarda kullanılabilecek kolay hesaplanabilen, objektif ve ucuz bir biyobelirteç olan PNI ile kalça kırıklarında malnütrisyon tanısı konarak optimize bir tedavi planı oluşturmak ve mortaliteyi azaltmak mümkün olabilir.

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İleri Yaş Kalça Kırığı Hastalarında Preoperatif Prognostik Beslenme İndeksinin Postoperatif Mortaliteyle İlişkisi

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References