Can the Neutrophil-to-Platelet Ratio Be Used to Predict Postoperative Mortality in Geriatric Patients with Hip Fractures?
Öz
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.
Material and Method: 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.
Anahtar Kelimeler
Kaynakça
- Wang ZC, Jiang W, Chen X, Yang L, Wang H, Liu YH. Systemic immune-inflammation index independently predicts poor survival of older adults with hip fracture: a prospective cohort study. BMC Geriatr 2021;21(1):155.
- Temiz A, Ersözlü S. Admission neutrophil-to-lymphocyte ratio and postoperative mortality in elderly patients with hip fracture. Ulus Travma Acil Cerrahi Derg 2019;25(1):71-74.
- Mutlu T, Daşar U. Hip fracture surgery in patients older than 90 years : evalution of factors that affect 30-day mortality in a particularly risky group. Turkish Journal of Geriatrics 2018;21 (2):279-284.
- Capkin S, Guler S, Ozmanevra R. C-reactive protein to albumin ratio may predict mortality for elderly population who undergo hemiarthroplasty due to hip fracture. J Invest Surg 2021;34(11):1272-1277.
- Temizel F, Uckun S, Kuzucuoglu T, Arslan G, Çevik B. The effects of comorbidities on intensive care admission in elderly patients undergoing hip surgerious. Turkish Journal of Geriatrics 2018;21 (2):109-114.
- Kasıkara H, Lafcı A. Evaluation of factors affecting mortality in geriatric hip fracture surgery: a retrospective study. Turkish Journal of Geriatrics 2022;25(3): 452-464.
- Stokes KY, Granger DN. Platelets: a critical link between inflammation and microvascular dysfunction. J Physiol 2012; 590(5):1023-1034.
- Norring-Agerskov D, Bathum L, Pedersen O et al. Biochemical markers of inflammation are associated with increased mortality in hip fracture patients: the Bispebjerg hip fracture biobank. Aging Clin Exp Res 2019;31(12):1727-1734.
- Saribal D, Hocaoglu-Emre FS, Erdogan S, Bahtiyar N, Caglar Okur S, Mert M. Inflammatory cytokines IL-6 and TNF-α in patients with hip fracture. Osteoporos Int. 2019;30(5):1025-1031.
- Yamamoto-Furusho JK, Mendieta-Escalante EA. Diagnostic utility of the neutrophil-platelet ratio as a novel marker of activity in patients with ulcerative colitis. PLoS One 2020;15(4):e0231988.
- Somaschini A, Cornara S, Demarchi A, et al. Neutrophil to platelet ratio: a novel prognostic biomarker in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention. Eur J Prev Cardiol 2020;27(19):2338-2340.
- He W, Ruan Y, Yuan C, et al. High neutrophil-to-platelet ratio is associated with hemorrhagic transformation in patients with acute ischemic stroke. Front Neurol 2019;10:1310.
- Li Z, Gao Q, Ren Z, Zhou H, Qian Z, Peng J. Nomogram based on neutrophil-to-platelet ratio to predict in-hospital mortality in infective endocarditis. Biomark Med. 2021 Oct;15(14):1233-1243
- Margraf A, Zarbock A. Platelets in inflammation and resolution. J Immunol 2019;203(9):2357-2367.
- Karahan MA. The effect of spinal anesthetic technique on neutrophil to lymphocyte ratio and postoperative mortality in elderly patients with coronary artery disease undergoing hip replacement surgery. Turkish Journal of Geriatrics 2019;22(3):305-314
- Gan L, Sun T, Li B, et al. Serum miR-146a and miR-150 as potential new biomarkers for hip fracture-induced acute lung injury. Mediators Inflamm 2018;2018:8101359
- Sokmen FC, Ulucakoy C. Can the c-reactive protein to albumin ratio predict mortality due to hemiarthroplasty performed after hip fracture in the elderly population? Turkish Journal of Geriatrics 2021;24(1): 79-86
- Wei XB, Liu YH, He PC, et al. The impact of admission neutrophil-to-platelet ratio on in-hospital and long-term mortality in patients with infective endocarditis. Clin Chem Lab Med 2017;55(6):899-906.
- Xu BY, Yan S, Low LL, Vasanwala FF, Low SG. Predictors of poor functional outcomes and mortality in patients with hip fracture: a systematic review. BMC Musculoskelet Disord. 2019;20(1):568.
- Biçen Ç, Akdemir M, Türken MA, Çekok K, Ekin A, Turan AC. Analysis of risk factors affecting mortality in elderly patients operated on for hip fractures: A retrospective comparative study. Acta Orthop Traumatol Turc. 2021;55(6):493-499.
- Yoo J, Lee JS, Kim S, et al. Length of hospital stay after hip fracture surgery and 1-year mortality. Osteoporos Int. 2019;30(1):145-153.
- Nikkel LE, Kates SL, Schreck M, Maceroli M, Mahmood B, Elfar JC. Length of hospital stay after hip fracture and risk of early mortality after discharge in New York state: retrospective cohort study. BMJ. 2015;351:h6246.
Kalça Kırığı Olan Geriatrik Hastalarda Postoperatif Mortalite Tahmininde Nötrofil-Platelet Oranı Kullanılabilir mi?
Öz
Amaç: Kalça kırığı, geriatrik hastalarda sıklıkla karşılaşılan bir durumdur ve yüksek postoperatif mortalite ve morbidite ile ilişkilidir. Mortaliteyi etkileyebilecek çok sayıda faktör vardır, ancak son çalışmalar inflamasyon ile ilişkisine odaklanmıştır. Nötrofil-platelet oranı, sistemik bir inflamasyon belirteci olarak kullanılmaktadır. Çalışmamızın amacı, kalça kırığı olan geriatrik hastalarda ameliyat öncesi nötrofil-platelet oranı (NPR) değerleri ile ameliyat sonrası bir yıllık mortalite arasındaki ilişkiyi incelemektir.
Gereç ve Yöntem: Retrospektif, çok merkezli çalışmamızda spinal anestezi altında kalça kırığı ameliyatı geçirmiş 65 yaş üstü 50 hasta incelendi. Hastaların preoperatif hastaneye yatış anındaki nötrofil-platelet oranı değerleri, yaşları, cinsiyetleri, Amerikan Anesteziyologlar Derneği skorları (ASA), kırık tipleri, komorbiditeleri, cerrahi süreleri, hastanede kalış süreleri ve postoperatif bir yıllık dönemde sağkalımları incelendi.
Bulgular: Tüm hastaların ortalama yaşı 85,44 ± 6,93 idi. Hastaların %60’ı kadın (n=30), %40’ı erkekti (n=20). Ameliyat öncesi nötrofil- platelet oranı için optimal cut-off değeri 38.286 olarak belirlendi. Hastanede kalış süresi ölen hastalarda 8,94 ± 3,05, yaşayan grupta 6,94 ± 2,63 gün (p=0,02) bulundu. Erkeklerde ölüm oranı kadınlara göre daha yüksekti (p=0,01).
Sonuç: Ameliyat öncesi nötrofil-platelet oranı değerinin 38.286’nın üzerinde olması, yaşlı kalça kırığı hastalarında ameliyat sonrası bir yıllık mortalitenin göstergesi olarak bulundu. Ayrıca hastanede kalış süresi ve erkek cinsiyetin mortalite ile ilişkili olduğu kanıtlanmıştır.
Anahtar Kelimeler
Kaynakça
- Wang ZC, Jiang W, Chen X, Yang L, Wang H, Liu YH. Systemic immune-inflammation index independently predicts poor survival of older adults with hip fracture: a prospective cohort study. BMC Geriatr 2021;21(1):155.
- Temiz A, Ersözlü S. Admission neutrophil-to-lymphocyte ratio and postoperative mortality in elderly patients with hip fracture. Ulus Travma Acil Cerrahi Derg 2019;25(1):71-74.
- Mutlu T, Daşar U. Hip fracture surgery in patients older than 90 years : evalution of factors that affect 30-day mortality in a particularly risky group. Turkish Journal of Geriatrics 2018;21 (2):279-284.
- Capkin S, Guler S, Ozmanevra R. C-reactive protein to albumin ratio may predict mortality for elderly population who undergo hemiarthroplasty due to hip fracture. J Invest Surg 2021;34(11):1272-1277.
- Temizel F, Uckun S, Kuzucuoglu T, Arslan G, Çevik B. The effects of comorbidities on intensive care admission in elderly patients undergoing hip surgerious. Turkish Journal of Geriatrics 2018;21 (2):109-114.
- Kasıkara H, Lafcı A. Evaluation of factors affecting mortality in geriatric hip fracture surgery: a retrospective study. Turkish Journal of Geriatrics 2022;25(3): 452-464.
- Stokes KY, Granger DN. Platelets: a critical link between inflammation and microvascular dysfunction. J Physiol 2012; 590(5):1023-1034.
- Norring-Agerskov D, Bathum L, Pedersen O et al. Biochemical markers of inflammation are associated with increased mortality in hip fracture patients: the Bispebjerg hip fracture biobank. Aging Clin Exp Res 2019;31(12):1727-1734.
- Saribal D, Hocaoglu-Emre FS, Erdogan S, Bahtiyar N, Caglar Okur S, Mert M. Inflammatory cytokines IL-6 and TNF-α in patients with hip fracture. Osteoporos Int. 2019;30(5):1025-1031.
- Yamamoto-Furusho JK, Mendieta-Escalante EA. Diagnostic utility of the neutrophil-platelet ratio as a novel marker of activity in patients with ulcerative colitis. PLoS One 2020;15(4):e0231988.
- Somaschini A, Cornara S, Demarchi A, et al. Neutrophil to platelet ratio: a novel prognostic biomarker in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention. Eur J Prev Cardiol 2020;27(19):2338-2340.
- He W, Ruan Y, Yuan C, et al. High neutrophil-to-platelet ratio is associated with hemorrhagic transformation in patients with acute ischemic stroke. Front Neurol 2019;10:1310.
- Li Z, Gao Q, Ren Z, Zhou H, Qian Z, Peng J. Nomogram based on neutrophil-to-platelet ratio to predict in-hospital mortality in infective endocarditis. Biomark Med. 2021 Oct;15(14):1233-1243
- Margraf A, Zarbock A. Platelets in inflammation and resolution. J Immunol 2019;203(9):2357-2367.
- Karahan MA. The effect of spinal anesthetic technique on neutrophil to lymphocyte ratio and postoperative mortality in elderly patients with coronary artery disease undergoing hip replacement surgery. Turkish Journal of Geriatrics 2019;22(3):305-314
- Gan L, Sun T, Li B, et al. Serum miR-146a and miR-150 as potential new biomarkers for hip fracture-induced acute lung injury. Mediators Inflamm 2018;2018:8101359
- Sokmen FC, Ulucakoy C. Can the c-reactive protein to albumin ratio predict mortality due to hemiarthroplasty performed after hip fracture in the elderly population? Turkish Journal of Geriatrics 2021;24(1): 79-86
- Wei XB, Liu YH, He PC, et al. The impact of admission neutrophil-to-platelet ratio on in-hospital and long-term mortality in patients with infective endocarditis. Clin Chem Lab Med 2017;55(6):899-906.
- Xu BY, Yan S, Low LL, Vasanwala FF, Low SG. Predictors of poor functional outcomes and mortality in patients with hip fracture: a systematic review. BMC Musculoskelet Disord. 2019;20(1):568.
- Biçen Ç, Akdemir M, Türken MA, Çekok K, Ekin A, Turan AC. Analysis of risk factors affecting mortality in elderly patients operated on for hip fractures: A retrospective comparative study. Acta Orthop Traumatol Turc. 2021;55(6):493-499.
- Yoo J, Lee JS, Kim S, et al. Length of hospital stay after hip fracture surgery and 1-year mortality. Osteoporos Int. 2019;30(1):145-153.
- Nikkel LE, Kates SL, Schreck M, Maceroli M, Mahmood B, Elfar JC. Length of hospital stay after hip fracture and risk of early mortality after discharge in New York state: retrospective cohort study. BMJ. 2015;351:h6246.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Geriatri ve Gerontoloji, Ortopedi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 10 Ekim 2023 |
| Gönderilme Tarihi | 24 Mayıs 2023 |
| Kabul Tarihi | 13 Temmuz 2023 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 5 Sayı: 3 |
Hitit Medical Journal Creative Commons Atıf-GayriTicari 4.0 Uluslararası Lisansı (CC BY NC) ile lisanslanmıştır.