Kalça kırığı olan geriatrik hastalarda trombosit, PDW, MPV değerlerinin mortalite üzerine etkileri
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Tarih
2022
Yazarlar
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Yayıncı
Dicle Üniversitesi, Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Dünya'da olduğu gibi Ülkemizde de geriatrik popülasyonda artış meydana gelmektedir. Bu artışla birlikte kalça kırığı vakalarında da artış görülmektedir. Mortalitesi ve morbiditesi yüksek bir hastalık olan kalça kırıklarında, yaş ilerledikçe mortalite oranı %30'lara kadar çıkmaktadır. Ortopedik aciller arasında en yaygın olarak uygulanan ameliyatlar, yaşlı hasta grubundaki kalça kırığı cerrahileridir. Özellikle çoklu komorbid gibi faktörlere sahip olan yaşlı hasta grubunda bu ameliyatlar, yüksek mortalite ile ilişkilidir. Kalça kırıklarında otuz günlük mortalite oranlarının %5-13, bir yıllık mortalitede ise %20-30 civarında olduğu kaydedilmiştir. Son yıllarda yapılan çalışmalarda Trombosit İndeksleri (PI) olarak bilinen Platelet (PLT), Ortalama Trombosit Hacmi (MPV) ve Trombosit Dağılım Genişliği (PDW) gibi parametrelerin trombosit aktivasyonunda biyo-belirteçler olduğu ifade edilmiştir. Hastaların hastalık seviyelerini değerlendirmede kullanılan bu parametreler, oldukça kolay ölçülebilmekte ve ek maliyete neden olmamaktadır. Hemostaz ve trombozdaki önemli görevleri olan trombositlerin oluşan inflamatuvar sürece, mikrobiyal konakçı savunmasına, yara iyileşmesine, anjiyogenezise ve yeniden modellemeye katkıda bulunduğu rapor edilmiştir. Literatürlerde trombosit indekslerinin tromboz, anjiogenez, inflamasyon ve bağışıklık aşamalarındaki rolleri de araştırıldığı kaydedilmiştir. Çalışmamız, Dicle Üniversitesi Tıp Fakültesi Hastanesi Acil Servis'inde yapılmıştır. 1 Aralık 2019 ile 1 Aralık 2020 tarihleri arasında başvuran geriatrik kalça kırığı olan hastaların verileri incelenerek yapılmıştır. Kabul kriterimiz, 65 yaş üstü olup kalça kırığı olan hem kadın hastalardan hem erkek hastalardan oluşmaktadır. Hastalara ait kan sonuçları ve kalça grafileri değerlendirilmiştir. İlgili klink görüşleri alınan hastaların, klinik görüşleri sonrasında cerrahi endikasyon olan hastalar ile cerrahi yapılmayan hastalar olarak incelenmiştir. Hastalar, kan sonuçlarıyla beraber değerlendirilmiştir. Kan tetkiklerinin Tam Kan sonuçlarında Trombosit, PDW ve MPV değerleri incelenmiştir. Kalça kırığı olup ölen hastalar ve yaşayan hastaların incelenen kan değerleri (Trombosit, PDW ve MPV) karşılaştırılmıştır. Ölen hastaların kan sonuçlarının mortaliteyle ilgisi araştırıldı.
As in the world, there is an increase in the geriatric population in our country. With this increase, there is an increase in hip fracture cases. In hip fractures, which is a disease with high mortality and morbidity, the mortality rate increases up to 30% with increasing age. The most commonly performed surgeries among orthopedic emergencies are hip fracture surgeries in the elderly patient group. Especially in the elderly patient group with multiple comorbid factors, these surgeries are associated with high mortality. Thirty-day mortality rates in hip fractures are 5-13%, and one-year mortality is around 20-30%.In recent studies, it has been stated that parameters such as Platelet (PLT), Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW), known as Platelet Indices (PI), are biomarkers in platelet activation. These parameters, which are used to evaluate the disease levels of patients, can be measured quite easily and do not cause additional costs. It has been reported that platelets, which have important roles in hemostasis and thrombosis, contribute to the inflammatory process, microbial host defense, wound healing, angiogenesis and remodeling. It has been noted in the literature that the roles of platelet indices in the stages of thrombosis, angiogenesis, inflammation and immunity have also been investigated. Our study was carried out in Dicle University Medical Faculty Hospital Emergency Service. The data of patients with geriatric hip fractures admitted between 1 December 2019 and 1 December 2020 were analyzed. Our admission criteria consisted of both male and female patients over 65 years of age with hip fractures. The blood results and hip radiographs of the patients were evaluated. The patients whose clinical opinions were taken were analyzed as patients with indications for surgery and patients who did not undergo surgery after their clinical opinions. The patients were evaluated together with their blood results. Platelet, PDW and MPV values were examined in Whole Blood results of blood tests. Examined blood values (Platelet, PDW and MPV) of patients who died with hip fractures and those who survived were compared. The correlation of blood results of deceased patients with mortality was investigated.
As in the world, there is an increase in the geriatric population in our country. With this increase, there is an increase in hip fracture cases. In hip fractures, which is a disease with high mortality and morbidity, the mortality rate increases up to 30% with increasing age. The most commonly performed surgeries among orthopedic emergencies are hip fracture surgeries in the elderly patient group. Especially in the elderly patient group with multiple comorbid factors, these surgeries are associated with high mortality. Thirty-day mortality rates in hip fractures are 5-13%, and one-year mortality is around 20-30%.In recent studies, it has been stated that parameters such as Platelet (PLT), Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW), known as Platelet Indices (PI), are biomarkers in platelet activation. These parameters, which are used to evaluate the disease levels of patients, can be measured quite easily and do not cause additional costs. It has been reported that platelets, which have important roles in hemostasis and thrombosis, contribute to the inflammatory process, microbial host defense, wound healing, angiogenesis and remodeling. It has been noted in the literature that the roles of platelet indices in the stages of thrombosis, angiogenesis, inflammation and immunity have also been investigated. Our study was carried out in Dicle University Medical Faculty Hospital Emergency Service. The data of patients with geriatric hip fractures admitted between 1 December 2019 and 1 December 2020 were analyzed. Our admission criteria consisted of both male and female patients over 65 years of age with hip fractures. The blood results and hip radiographs of the patients were evaluated. The patients whose clinical opinions were taken were analyzed as patients with indications for surgery and patients who did not undergo surgery after their clinical opinions. The patients were evaluated together with their blood results. Platelet, PDW and MPV values were examined in Whole Blood results of blood tests. Examined blood values (Platelet, PDW and MPV) of patients who died with hip fractures and those who survived were compared. The correlation of blood results of deceased patients with mortality was investigated.
Açıklama
Anahtar Kelimeler
Kalça kırığı, Geriatri, Trombosit, Mortalite, Hip fracture, Geriatrics, Platelet, Mortality
Kaynak
WoS Q Değeri
Scopus Q Değeri
Cilt
Sayı
Künye
Özkan, H. (2022). Kalça kırığı olan geriatrik hastalarda trombosit, PDW, MPV değerlerinin mortalite üzerine etkileri. Yayımlanmamış uzmanlık tezi, Dicle Üniversitesi, Diyarbakır.
