Öz

Amaç: Bu çalışmanın amacı, cerrahi yoğun bakım ünitesinde (SICU) takip edilen kritik geriatrik kalça fraktürlü hastalarda Charlson komorbidite indeksi (CCI), Amerikan Anestezistler Derneği (ASA) statüsü ve Akut Fizyoloji ve Kronik Hastalık Değerlendirmesi II (APACHE-II) skorunun prognostik değerinin araştırılmasıdır.

Gereç ve Yöntem: Ocak 2022 ile Aralık 2023 tarihleri arasında operasyon gerçekleştirilen ve SICU’da takip edilen kritik geriatrik kalça fraktürlü hastalar retrospektif olarak değerlendirildi.. CCI, ASA statüsü ve APACHE-II skorlarının hastane içi mortaliteyi öngörebilme performansları araştırıldı.

Bulgular: Çalışmaya 137 hasta dahil edildi ve %66.4’ü (n=91) kadın idi. Mortalite grubunda ASA IV statüsü, APACHE-II, CCI skoru ve koroner vasküler hastalık/kalp yetmezlikli hasta sayısı anlamlı olarak yüksekti (sırasıyla p=0.003, p<0.001, p<0.001 ve p=0.010). Mortalite grubunda SICU’ya kabul sırasındaki ortalama Glasgow Koma Skalası ve serum albumin düzeyleri anlamlı olarak düşüktü (sırasıyla p=0.008 ve p=0.006). ASA statüsü, APACHE-II ve CCI skorları mortalitenin bağımsız prediktörleri idi (sırasıyla p=0.002, p=0.022 ve p=0.034). ROC curve analizinde APACHE-II için eğri altındaki alanı (AUC)= 0.803 (%95 CI, 0.697-0.908), CCI için AUC=0.742 (%95 CI, 0.598-0.886) ve ASA statüsü için AUC=0.614 (%95 CI, 0.458-0.769) saptandı.

Sonuç: Kritik kalça fraktürlü hastalarda CCI, ASA statüsü ve APACHE-II skorları hastane içi mortalitenin bağımsız prediktörleridir. Mortalite öngörmede prognostik değere sahip olmakla birlikte büyükten küçüğe APACHE-II, CCI ve ASA statüsü şeklinde sıralanmaktadır.

Anahtar Kelimeler: kalça fraktürü, Charlson comorbidity indeks, ASA, APACHE-II, hastane içi mortalite

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Arslan K, Şahin AS. Kritik geriatrik kalça fraktürlü hastalarda Charlson komorbidite indeksi, ASA statüsü ve APACHE-II skorunun hastane içi mortaliteyi öngörmede prognostik değeri. Turk J Intensive Care. 2025;Early View:1-11. https://doi.org/10.63729/TJIC.2025.669