Research Article
BibTex RIS Cite

Yaşlı Politravma Hastalarında Mortaliteyi Etkileyen Faktörler Genç Hastalardan Farklı mıdır?

Year 2020, Volume: 27 Issue: 4, 511 - 517, 25.12.2020

Buket Altun Özdemir Güzelali Özdemir Niyazi Yaşar Olgun Bingöl Hakan Ataş Bülent Çomçalı

https://doi.org/10.17343/sdutfd.757460

Abstract

Amaç: Bu çalışmanın amacı, genç ve yaşlı politravma hastaları arasındaki mortalite farklılıklarını değerlendirmektir.
Gereç ve Yöntem: Bu çalışmada Ocak 2014-Aralık 2018 tarihleri arasında hastanemizde tedavi edilen politravma hastalarının tümü retrospektif olarak incelendi. 65 yaşından küçük hastalar Grup I (n = 60), 65 yaş ve üstü hastalar Grup II (n = 60) olarak sınıflandırıldı. Yaş, cinsiyet, yaralanma mekanizması, yaralanma süresi, yaralanma ciddiyeti skoru (YCS), klinik öncesi hemodinami, hastaneye yatış, operatif tedavi, entübasyon oranı, yoğun bakım ünitesinde (YBÜ) tedavi ve 1 yıllık mortalite analiz edildi. Nötrofil-lenfosit oranı, monosit-lenfosit oranı ve sistemik inflamasyon yanıt indeksi hesaplandı.
Bulgular: Grup I'de yaş ortalaması 36,6 ± 13,0 (18-64), Grup II'de 73,5 ± 7,4 (56-91) idi. Gruplar arasında mortalite oranları arasında fark yoktu. Yaşlı politravma hastaları genellikle yaz aylarında kadın, daha düşük YCS, daha yüksek kan basıncı ve düşük enerjili yaralanma tipinde olma eğilimindedir. Grup I ve Grup II'de mortalite ve YCS skorları arasında istatistiksel olarak anlamlı bir pozitif korelasyon bulundu. Nötrofil-lenfosit oranı, monosit-lenfosit oranı ve sistemik inflamasyon yanıt indeksi skorları açısından yaşlı ve genç politravma hastaları arasında istatistiksel olarak anlamlı bir fark bulunmadı.
Sonuç: Yaşlı politravma hastaları sadece yaşlı yetişkinler değildir ve bunlar ile genç hastalar arasında çeşitli farklılıklar vardır. Yaşlı politravma hastalarının tedavisinin karar verme sürecinde mevcut farklılıkların göz önünde bulundurulması gerekmektedir.

Keywords

Yaşlı politravma mortalite politravma

References

  • 1. Aldrian S, Nau T, Koenig F, Vecsei V. Geriatric polytrauma. Wien Klin Wochenschr. 2005 Feb;117(4):145–9.
  • 2. van der Sluis CK, Klasen HJ, Eisma WH, ten Duis HJ. Major trauma in young and old: what is the difference? J Trauma. 1996 Jan;40(1):78–82.
  • 3. Giannoudis P V, Harwood PJ, Court-Brown C, Pape HC. Severe and multiple trauma in older patients; incidence and mortality. Injury. 2009 Apr;40(4):362–7.
  • 4. Tornetta P 3rd, Mostafavi H, Riina J, Turen C, Reimer B, Levine R, et al. Morbidity and mortality in elderly trauma patients. J Trauma. 1999 Apr;46(4):702–6.
  • 5. Hashmi A, Ibrahim-Zada I, Rhee P, Aziz H, Fain MJ, Friese RS, et al. Predictors of mortality in geriatric trauma patients: a systematic review and meta-analysis. J Trauma Acute Care Surg. 2014 Mar;76(3):894–901.
  • 6. Sammy I, Lecky F, Sutton A, Leaviss J, O’Cathain A. Factors affecting mortality in older trauma patients-A systematic review and meta-analysis. Injury. 2016 Jun;47(6):1170–83.
  • 7. Zietlow SP, Capizzi PJ, Bannon MP, Farnell MB. Multisystem geriatric trauma. J Trauma. 1994 Dec;37(6):985–8.
  • 8. Djordjevic D, Rondovic G, Surbatovic M, Stanojevic I, Udovicic I, Andjelic T, et al. Neutrophil-to-Lymphocyte Ratio, Monocyte-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Mean Platelet Volume-to-Platelet Count Ratio as Biomarkers in Critically Ill and Injured Patients: Which Ratio to Choose to Predict Outcome and Nature of Bacte. Mediators Inflamm. 2018;2018:3758068.
  • 9. Demetriades D, Murray J, Sinz B, Myles D, Chan L, Sathyaragiswaran L, et al. Epidemiology of major trauma and trauma deaths in Los Angeles County. J Am Coll Surg. 1998 Oct;187(4):373–83.
  • 10. Champion HR, Copes WS, Buyer D, Flanagan ME, Bain L, Sacco WJ. Major trauma in geriatric patients. Am J Public Health. 1989 Sep;79(9):1278–82.
  • 11. Horst HM, Obeid FN, Sorensen VJ, Bivins BA. Factors influencing survival of elderly trauma patients. Crit Care Med. 1986 Aug;14(8):681–4.
  • 12. Rupprecht H, Heppner HJ, Wohlfart K, Turkoglu A. The geriatric polytrauma: Risk profile and prognostic factors. Ulus Travma Acil Cerrahi Derg. 2017 Mar;23(2):156–62.
  • 13. Bouamra O, Wrotchford A, Hollis S, Vail A, Woodford M, Lecky F. A new approach to outcome prediction in trauma: A comparison with the TRISS model. J Trauma. 2006 Sep;61(3):701–10.
  • 14. Aitken LM, Burmeister E, Lang J, Chaboyer W, Richmond TS. Characteristics and outcomes of injured older adults after hospital admission. J Am Geriatr Soc. 2010 Mar;58(3):442–9.
  • 15. Richmond TS, Kauder D, Strumpf N, Meredith T. Characteristics and outcomes of serious traumatic injury in older adults. J Am Geriatr Soc. 2002 Feb;50(2):215–22.
  • 16. Lionakis N, Mendrinos D, Sanidas E, Favatas G, Georgopoulou M. Hypertension in the elderly. World J Cardiol. 2012 May;4(5):135–47.
  • 17. Zahorec R. Ratio of neutrophil to lymphocyte counts--rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy. 2001;102(1):5–14.
  • 18. Vaughan-Shaw PG, Rees JRE, King AT. Neutrophil lymphocyte ratio in outcome prediction after emergency abdominal surgery in the elderly. Int J Surg. 2012;10(3):157–62.
  • 19. Tan TP, Arekapudi A, Metha J, Prasad A, Venkatraghavan L. Neutrophil-lymphocyte ratio as predictor of mortality and morbidity in cardiovascular surgery: a systematic review. ANZ J Surg. 2015 Jun;85(6):414–9.
  • 20. Templeton AJ, McNamara MG, Šeruga B, Vera-Badillo FE, Aneja P, Ocaña A, et al. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst. 2014 Jun;106(6):dju124.
  • 21. Paramanathan A, Saxena A, Morris DL. A systematic review and meta-analysis on the impact of pre-operative neutrophil lymphocyte ratio on long term outcomes after curative intent resection of solid tumours. Surg Oncol. 2014 Mar;23(1):31–9.
  • 22. Malietzis G, Giacometti M, Kennedy RH, Athanasiou T, Aziz O, Jenkins JT. The emerging role of neutrophil to lymphocyte ratio in determining colorectal cancer treatment outcomes: a systematic review and meta-analysis. Ann Surg Oncol. 2014 Nov;21(12):3938–46.
  • 23. Hermanns T, Bhindi B, Wei Y, Yu J, Noon AP, Richard PO, et al. Pre-treatment neutrophil-to-lymphocyte ratio as predictor of adverse outcomes in patients undergoing radical cystectomy for urothelial carcinoma of the bladder. Br J Cancer. 2014;111(3):444–51.
  • 24. Hu P, Shen H, Wang G, Zhang P, Liu Q, Du J. Prognostic significance of systemic inflammation-based lymphocyte-monocyte ratio in patients with lung cancer: based on a large cohort study. PLoS One. 2014;9(10).
  • 25. Nishijima TF, Muss HB, Shachar SS, Tamura K, Takamatsu Y. Prognostic value of lymphocyte-to-monocyte ratio in patients with solid tumors: a systematic review and meta-analysis. Cancer Treat Rev. 2015;41(10):971–8.
  • 26. Zhang Y, Wang L, Liu Y, Wang S, Shang P, Gao Y, et al. Preoperative neutrophil-lymphocyte ratio before platelet-lymphocyte ratio predicts clinical outcome in patients with cervical cancer treated with initial radical surgery. Int J Gynecol Cancer. 2014;24(7):1319–25.
  • 27. Qi Q, Zhuang L, Shen Y, Geng Y, Yu S, Chen H, et al. A novel systemic inflammation response index (SIRI) for predicting the survival of patients with pancreatic cancer after chemotherapy. Cancer. 2016 Jul;122(14):2158–67.
  • 28. Chen Z, Wang K, Lu H, Xue D, Fan M, Zhuang Q, et al. Systemic inflammation response index predicts prognosis in patients with clear cell renal cell carcinoma: a propensity score-matched analysis. Cancer Manag Res. 2019;11:909–19.
  • 29. Xu L, Yu S, Zhuang L, Wang P, Shen Y, Lin J, et al. Systemic inflammation response index (SIRI) predicts prognosis in hepatocellular carcinoma patients. Oncotarget. 2017 May;8(21):34954–60.
  • 30. Li S, Xu H, Wang W, Gao H, Li H, Zhang S, et al. The systemic inflammation response index predicts survival and recurrence in patients with resectable pancreatic ductal adenocarcinoma. Cancer Manag Res. 2019;11:3327.

Are the Factors Affecting Mortality in Elderly Polytrauma Patients Different from Those Affecting Younger Patients?

Year 2020, Volume: 27 Issue: 4, 511 - 517, 25.12.2020

Buket Altun Özdemir Güzelali Özdemir Niyazi Yaşar Olgun Bingöl Hakan Ataş Bülent Çomçalı

https://doi.org/10.17343/sdutfd.757460

Abstract

Objectives: The purpose of this study was to evaluate the differences in mortality between young and elderly polytrauma patients.
Materials and Methods: In the present study, all consecutive polytrauma patients treated at our hospital between January 2014 and December 2018 were reviewed retrospectively. Patients younger than 65 years old were classified as Group I (n = 60), and patients aged 65 years and older were classified as Group II (n = 60). Age, gender, mechanism of injury, time of injury, injury severity score (ISS), preclinical hemodynamics, hospitalization, operative treatment, intubation rate, intensive care unit (ICU) treatment, and 1-year mortality were analyzed. The neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and systemic inflammation response index (SIRI) were calculated.
Results: The mean age was 36.6 ± 13.0 (18–64) years in Group I and 73.5 ± 7.4 (56–91) years in Group II. There was no difference in mortality rates between groups. Elderly polytrauma patients tend to be female, and lower ISS and higher blood pressure, as well as low-energy injury types, typically in the summer. A statistically significant positive correlation was found between mortality and ISS scores in both Group I and Group II. There was no statistically significant difference was found between elderly and younger polytrauma patients in terms of NLR, MLR, and SIRI scores.
Conclusion: Elderly polytrauma patients are not just older adults, and there are several differences between them and their younger counterparts. The existing differences in the treatment of elderly polytrauma patients need to be considered during decision making.

Keywords

Elderly polytrauma mortality polytrauma

References

  • 1. Aldrian S, Nau T, Koenig F, Vecsei V. Geriatric polytrauma. Wien Klin Wochenschr. 2005 Feb;117(4):145–9.
  • 2. van der Sluis CK, Klasen HJ, Eisma WH, ten Duis HJ. Major trauma in young and old: what is the difference? J Trauma. 1996 Jan;40(1):78–82.
  • 3. Giannoudis P V, Harwood PJ, Court-Brown C, Pape HC. Severe and multiple trauma in older patients; incidence and mortality. Injury. 2009 Apr;40(4):362–7.
  • 4. Tornetta P 3rd, Mostafavi H, Riina J, Turen C, Reimer B, Levine R, et al. Morbidity and mortality in elderly trauma patients. J Trauma. 1999 Apr;46(4):702–6.
  • 5. Hashmi A, Ibrahim-Zada I, Rhee P, Aziz H, Fain MJ, Friese RS, et al. Predictors of mortality in geriatric trauma patients: a systematic review and meta-analysis. J Trauma Acute Care Surg. 2014 Mar;76(3):894–901.
  • 6. Sammy I, Lecky F, Sutton A, Leaviss J, O’Cathain A. Factors affecting mortality in older trauma patients-A systematic review and meta-analysis. Injury. 2016 Jun;47(6):1170–83.
  • 7. Zietlow SP, Capizzi PJ, Bannon MP, Farnell MB. Multisystem geriatric trauma. J Trauma. 1994 Dec;37(6):985–8.
  • 8. Djordjevic D, Rondovic G, Surbatovic M, Stanojevic I, Udovicic I, Andjelic T, et al. Neutrophil-to-Lymphocyte Ratio, Monocyte-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio, and Mean Platelet Volume-to-Platelet Count Ratio as Biomarkers in Critically Ill and Injured Patients: Which Ratio to Choose to Predict Outcome and Nature of Bacte. Mediators Inflamm. 2018;2018:3758068.
  • 9. Demetriades D, Murray J, Sinz B, Myles D, Chan L, Sathyaragiswaran L, et al. Epidemiology of major trauma and trauma deaths in Los Angeles County. J Am Coll Surg. 1998 Oct;187(4):373–83.
  • 10. Champion HR, Copes WS, Buyer D, Flanagan ME, Bain L, Sacco WJ. Major trauma in geriatric patients. Am J Public Health. 1989 Sep;79(9):1278–82.
  • 11. Horst HM, Obeid FN, Sorensen VJ, Bivins BA. Factors influencing survival of elderly trauma patients. Crit Care Med. 1986 Aug;14(8):681–4.
  • 12. Rupprecht H, Heppner HJ, Wohlfart K, Turkoglu A. The geriatric polytrauma: Risk profile and prognostic factors. Ulus Travma Acil Cerrahi Derg. 2017 Mar;23(2):156–62.
  • 13. Bouamra O, Wrotchford A, Hollis S, Vail A, Woodford M, Lecky F. A new approach to outcome prediction in trauma: A comparison with the TRISS model. J Trauma. 2006 Sep;61(3):701–10.
  • 14. Aitken LM, Burmeister E, Lang J, Chaboyer W, Richmond TS. Characteristics and outcomes of injured older adults after hospital admission. J Am Geriatr Soc. 2010 Mar;58(3):442–9.
  • 15. Richmond TS, Kauder D, Strumpf N, Meredith T. Characteristics and outcomes of serious traumatic injury in older adults. J Am Geriatr Soc. 2002 Feb;50(2):215–22.
  • 16. Lionakis N, Mendrinos D, Sanidas E, Favatas G, Georgopoulou M. Hypertension in the elderly. World J Cardiol. 2012 May;4(5):135–47.
  • 17. Zahorec R. Ratio of neutrophil to lymphocyte counts--rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy. 2001;102(1):5–14.
  • 18. Vaughan-Shaw PG, Rees JRE, King AT. Neutrophil lymphocyte ratio in outcome prediction after emergency abdominal surgery in the elderly. Int J Surg. 2012;10(3):157–62.
  • 19. Tan TP, Arekapudi A, Metha J, Prasad A, Venkatraghavan L. Neutrophil-lymphocyte ratio as predictor of mortality and morbidity in cardiovascular surgery: a systematic review. ANZ J Surg. 2015 Jun;85(6):414–9.
  • 20. Templeton AJ, McNamara MG, Šeruga B, Vera-Badillo FE, Aneja P, Ocaña A, et al. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst. 2014 Jun;106(6):dju124.
  • 21. Paramanathan A, Saxena A, Morris DL. A systematic review and meta-analysis on the impact of pre-operative neutrophil lymphocyte ratio on long term outcomes after curative intent resection of solid tumours. Surg Oncol. 2014 Mar;23(1):31–9.
  • 22. Malietzis G, Giacometti M, Kennedy RH, Athanasiou T, Aziz O, Jenkins JT. The emerging role of neutrophil to lymphocyte ratio in determining colorectal cancer treatment outcomes: a systematic review and meta-analysis. Ann Surg Oncol. 2014 Nov;21(12):3938–46.
  • 23. Hermanns T, Bhindi B, Wei Y, Yu J, Noon AP, Richard PO, et al. Pre-treatment neutrophil-to-lymphocyte ratio as predictor of adverse outcomes in patients undergoing radical cystectomy for urothelial carcinoma of the bladder. Br J Cancer. 2014;111(3):444–51.
  • 24. Hu P, Shen H, Wang G, Zhang P, Liu Q, Du J. Prognostic significance of systemic inflammation-based lymphocyte-monocyte ratio in patients with lung cancer: based on a large cohort study. PLoS One. 2014;9(10).
  • 25. Nishijima TF, Muss HB, Shachar SS, Tamura K, Takamatsu Y. Prognostic value of lymphocyte-to-monocyte ratio in patients with solid tumors: a systematic review and meta-analysis. Cancer Treat Rev. 2015;41(10):971–8.
  • 26. Zhang Y, Wang L, Liu Y, Wang S, Shang P, Gao Y, et al. Preoperative neutrophil-lymphocyte ratio before platelet-lymphocyte ratio predicts clinical outcome in patients with cervical cancer treated with initial radical surgery. Int J Gynecol Cancer. 2014;24(7):1319–25.
  • 27. Qi Q, Zhuang L, Shen Y, Geng Y, Yu S, Chen H, et al. A novel systemic inflammation response index (SIRI) for predicting the survival of patients with pancreatic cancer after chemotherapy. Cancer. 2016 Jul;122(14):2158–67.
  • 28. Chen Z, Wang K, Lu H, Xue D, Fan M, Zhuang Q, et al. Systemic inflammation response index predicts prognosis in patients with clear cell renal cell carcinoma: a propensity score-matched analysis. Cancer Manag Res. 2019;11:909–19.
  • 29. Xu L, Yu S, Zhuang L, Wang P, Shen Y, Lin J, et al. Systemic inflammation response index (SIRI) predicts prognosis in hepatocellular carcinoma patients. Oncotarget. 2017 May;8(21):34954–60.
  • 30. Li S, Xu H, Wang W, Gao H, Li H, Zhang S, et al. The systemic inflammation response index predicts survival and recurrence in patients with resectable pancreatic ductal adenocarcinoma. Cancer Manag Res. 2019;11:3327.
There are 30 citations in total.

Details

Primary Language English
Subjects Surgery
Journal Section Araştırma Makaleleri
Authors

Buket Altun Özdemir 0000-0002-1043-8108

Güzelali Özdemir 0000-0003-4279-0955

Niyazi Yaşar This is me 0000-0002-6740-6422

Olgun Bingöl 0000-0003-1720-1709

Hakan Ataş 0000-0003-4144-417X

Bülent Çomçalı 0000-0002-2111-1477

Publication Date December 25, 2020
Submission Date June 24, 2020
Acceptance Date July 16, 2020
Published in Issue Year 2020 Volume: 27 Issue: 4

Cite

Vancouver Altun Özdemir B, Özdemir G, Yaşar N, Bingöl O, Ataş H, Çomçalı B. Are the Factors Affecting Mortality in Elderly Polytrauma Patients Different from Those Affecting Younger Patients?. Med J SDU. 2020;27(4):511-7.
 Download Cover Image

                                                                                               14791 


Süleyman Demirel Üniversitesi Tıp Fakültesi Dergisi/Medical Journal of Süleyman Demirel University is licensed under Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International.