Uticaj polnih razlika na mortalitet starijih bolesnika nakon preloma kuka

  • Tanja T Prodović University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Serbia
  • Branko M. Ristić University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Serbia
  • Dušan D. Vučetić Military Medical Academy, Institute for Transfusiology and Hemobiology, Belgrade, Serbia
  • Dragana I. Ignjatović Ristić University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Serbia
DOI: https://doi.org/10.2298/VSP161122022P
Ključne reči: kuk, prelomi;, stare osobe;, faktori rizika;, pol;, mortalitet;, komorbiditet;, srbija.

Sažetak


Uvod/Cilj. Prelom kuka je jedan od vodećih uzroka smrti u starijoj populaciji. Analiziran je uticaj polnih razlika na stope mortaliteta starijih bolesnika sa pre­lo­mom kuka. Metode. U studiji su bili uključeni svi ho­spitalizovani bolesnici stariji od 65 godina sa pre­lo­mom kuka tokom 2013. godine. Bolesnici su bili podeljeni u četiri grupe rizika, mali, srednji, visok i veoma visok, u skladu sa institucionalnom Sisli Etfal ska­lom za procenu faktora rizika postoperativnog morta­liteta (institutional Şişli Etfal risk factor assessment scale – ISERFAS). Kli­nički, laboratorijski i rizik rezultati upoređeni su prema polu između preživelih i umrlih bolesnika. Praćen je bolnički, tromesečni i šestomesečni mortalitet bole­sni­ka. Prediktivni uticaj pola i ukupnog rizika na stope mortaliteta testirane su univarijantnom i multi­vari­jant­nom regresionom analizom dobijenih rezultata. Re­zultati. Kompletni uzorak činilo je 434 ženskih i 163 muških bolesnika. Prosečna starost muškaraca je bila 77,95, a žena 79,18 godina. Prelom vrata butne kosti bio je češći kod žena (44,5%), bez statističkI značajnosti (p = 0.57). Pokazana je značajne razlike u odnosu na muškarce razlika između polova u odnosu na rizik skor (p = 0,024). Kod ženskih bolesnika primećen je niži ste­pen rizika, dok je kod muškaraca primećen viši. Kumulativni mortalitet bio je 6% tokom hospitalizacije, 17,8% nakon tri, odnosno 25% nakon šest meseci. Stope bolničkog i šestomesečnog mortaliteta bile su slične kada je u pitanju pol, jedino  su muškarci značajno češće umirali (p = 0.035) tri meseca nakon povrede. Ukupan rizik je na svim posmatranim tačkama mortaliteta (p= 0.000) bio značajan prediktor sam po sebi. Samostalni prediktorni uticaj pola se gubio u sadejstvu sa ukupnim rizikom. Zaključak. Pol se može definisati kao značajan prediktor mortaliteta kod bolesnika sa prelomom kuka. Sistem ocenjivanja rizika u proceni postoperativne smrtnosti usled prelom kuka mogao bi biti od pomoći u planiranju tretmana za svakog bolesnika.

Biografije autora

Branko M. Ristić, University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Serbia

Clinic for Orthopedic Surgery and Traumatology, Clinical Center Kragujevac, Zmaj Jovina 30, 34 000 Kragujevac, Serbia

Dušan D. Vučetić, Military Medical Academy, Institute for Transfusiology and Hemobiology, Belgrade, Serbia

Institute for Transfusiology and Hemobiology, Military Medical Academy, Belgrade, Serbia

Dragana I. Ignjatović Ristić, University of Kragujevac, Faculty of Medical Sciences, Kragujevac, Serbia

Psychiatric Clinic, Clinical Center Kragujevac, Zmaj Jovina 30, 34 000 Kragujevac, Serbia

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2020/12/08
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Vol. 75 Br. 9 (2018): September Vol. 75 (No. 9)
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