Kan alb�min ve total lenfosit says�n�n ileri ya� kal�a k�r�kl� olgularda k�sa d�nem sonu�lar�n�n �zerine etkileri

�zt�rk, Alpaslan; �zkan, Y�ksel; Akg�z, Semra; Yal��n, Nazan; Aykut, Serkan; �zdemir, Mehmet Recai

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Kan alb�min ve total lenfosit says�n�n ileri ya� kal�a k�r�kl� olgularda k�sa d�nem sonu�lar�n�n �zerine etkileri [Ulus Travma Acil Cerrahi Derg]

Ulus Travma Acil Cerrahi Derg. 2009; 15(6): 546-552

Kan alb�min ve total lenfosit says�n�n ileri ya� kal�a k�r�kl� olgularda k�sa d�nem sonu�lar�n�n �zerine etkileri

Alpaslan �zt�rk¹, Y�ksel �zkan¹, Semra Akg�z², Nazan Yal��n¹, Serkan Aykut¹, Mehmet Recai �zdemir¹
¹Bursa Y�ksek �htisas E�itim Ve Ara�t�rma Hastanesi Ortopedi Ve Travmatoloji Klini�i
²�anakkale 18 Mart �niversitesi T�p Fak�ltesi �statistik Ana Bilim Dal�

AMA�
Yetmi� d�rt ileri ya� kal�a k�r�kl� hastada kan alb�min ve �total lenfosit say�s��n�n (TLS) ameliyat sonras� 1 y�ll�k d�nemdeki etkileri de�erlendirildi.
GERE� VE Y�NTEM
2006 y�l�nda 65 ya� ve �st� 74 (52 kad�n, 22 erkek) hasta �al��ma kapsam�na al�nd�. Ba�vuru an�ndaki alb�min ve TLS kaydedildi. Bunlar ile mortalite, hastanede kal�� s�resi ve y�r�yebilme becerisi aras�ndaki ili�ki ara�t�r�ld�. Y�r�yebilme becerisi Parkland ve Palmer �l��tleri ile de�erlendirildi.
BULGULAR
Hastalar�n 61�inin ya�� 65-84 olup 13�� ise 85-105 idi. Hastalar�n 41�inde (%55,4) hipoalb�minemi ve 23��nde (%31,08) ise d��k TLS saptand�. Alb�min d�zeyi ve TLS d��k olan hastalarda mortalite daha y�ksekti (p=0,011). Ayr�ca, alb�min d�zeyi d��k oldu�unda hastanede yatma s�resi daha uzundu (p=0,002). Alb�min d�zeyleri ile TLS normal olan hastalarda daha iyi fonksiyonu g�steren y�r�yebilme becerisi ile ilgili puanlar daha y�ksek olarak bulundu (p=0,012). �leri ya��n mortalite ve fonksiyonel sonu�lara etkisi bulunmad� (p>0,05). �ok de�i�kenli analiz sonucunda d��k TLS, ASA 3-4 ve kad�n cinsiyetin ameliyat sonras� bir y�ll�k d�nemde mortaliteyi etkileyen g��l� ve ba��ms�z etkenler oldu�u bulundu. Tek ba��na hi�bir kan parametresinin y�r�yebilme becerisi �zerine etkisi saptanmad�.
SONU�
�leri ya� kal�a k�r�kl� hastalarda mortalite riski kad�n cinsiyet, ASA 3-4 ve d��k lenfosit say�s� varl��nda artmaktad�r. Hipoalb�minemili hastalarda hastanede kal�� s�resi daha uzun olmaktad�r. Bu risk fakt�rlerinin saptanmas� olgularda daha iyi sonu� almaya yard�mc� olabilir.

Anahtar Kelimeler: Y�r�yebilme becerisi, hipoalb�minemi; total lenfosit say�s�; mortalite.

The effect of blood albumin and total lymphocyte counton short-term results in elderly patients with hip fractures

Alpaslan �zt�rk¹, Y�ksel �zkan¹, Semra Akg�z², Nazan Yal��n¹, Serkan Aykut¹, Mehmet Recai �zdemir¹
¹Bursa High Specialty Research And Training Hospital Clinic Of Orthopaedics And Traumatology
²�anakkale 18 Mart University Medical School Department Of Statistics

BACKGROUND
A study was performed to determine the effects of blood albumin and total lymphocyte count on the postoperative one-year period in 74 elderly hip fracture patients.
METHODS
In 2006, 74 patients (52 female, 22 male) with hip fracture who were 65 years of age or older were included in the study. Admission albumin levels and total lymphocyte counts were recorded. The outcomes examined were mortality, length of hospital stay and ambulatory ability. Ambulatory ability was assessed according to Parkland and Palmer criteria.
RESULTS
There were 61 patients aged 65-84 years, and 13 patients aged 85-105 years. Forty-one patients (55.4%) had hypoalbuminemia and 23 patients (31.1%) had low total lymphocyte count. Low albumin and total lymphocyte counts were associated with higher mortality (p=0.011). Patients with low albumin levels had longer length of hospital stay (p=0.002). Patients with normal albumin and total lymphocyte counts had higher mobility score meaning better function (p=0.012). Multivariate analysis yielded that low total lymphocyte count, American Society of Anesthesiologists (ASA) 3-4 and female gender remained significant independent predictors of one-year mortality. No single blood parameter was found to be effective on ambulatory status.
CONCLUSION
Risk of mortality in elderly hip fracture patients increases with female gender, ASA 3-4 and low total lymphocyte counts. Hypoalbuminemia is associated with longer hospitalization. Identification of these risk factors can help in the case management for a more favorable outcome.

Keywords: Ambulatory status, hypoalbuminemia; total lymphocyte count; mortality.

Alpaslan �zt�rk, Y�ksel �zkan, Semra Akg�z, Nazan Yal��n, Serkan Aykut, Mehmet Recai �zdemir. The effect of blood albumin and total lymphocyte counton short-term results in elderly patients with hip fractures. Ulus Travma Acil Cerrahi Derg. 2009; 15(6): 546-552

Sorumlu Yazar: Alpaslan �zt�rk, T�rkiye
Makale Dili: �ngilizce

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