Tıp Fakültesi / Faculty of Medicine

Permanent URI for this collectionhttps://hdl.handle.net/11727/1403

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    The Impact of Comorbidities on Mortality in Patients with Non-Traumatic Major Lower Extremity Amputation
    (2023) Yagiz, Betul Keskinkilic; Goktug, Ufuk Utku; Sapmaz, Ali; Dinc, Tolga; Budak, Ali Baran; Terzioglu, Serdar Gokay; 38060412
    Objective: Major lower limb amputation is generally associated with a high risk of early and late-term mortality. In this study, 30-day, one-year and three-year mortality of non-traumatic major lower extremity amputations and comorbidities affecting the mortality rate were investigated. Method: Patients who underwent a major lower limb amputation secondary to diabetes or peripheral artery disease between the years 2010-2015 were retrospectively evaluated. Additional to patient demographic data and comorbidities, amputation level, survival and mortality time were extracted. Mortality rates after 30 days, one year and three years were analysed. The associations of the survival to different parameters were evaluated with Kaplan-Meier analysis and log rank test, while the impact of the risk factors on mortality was evaluated with the Cox regression test. Results: A total of 193 patients were enrolled in the study. Approximately 60% of patients were aged >= 65 years, and 65.8% were male. Below-knee amputation was performed in 64.8% of patients and above-knee amputation in 35.2% of patients. The mean follow-up of patients was 29.48 months (range: 0-101 months). After non-traumatic major lower extremity amputation, 30-day, one-year and three-year mortality were 16.6%, 38.3% and 60.1%, respectively. On Cox regression analysis, age >= 65 years was the only variable that had significant impact on the 30-day mortality (hazard ratio (HR): 3.4; p=0.012), while age >= 65 years (HR: 2.5, p=0.000), diabetes (HR: 2, p=0.006) and renal failure (HR: 2, p=0.001) were found to have significant impacts on three-year mortality. Conclusion: The findings of this study showed that >50% of patients with non-traumatic major lower limb amputations died within three years. Advanced age, diabetes and renal failure were the risk factors that increased the mortality. The high mortality rates revealed the importance of employing all hard-to-heal wound treatment options before making an amputation decision. Further, prospective studies are needed to determine the effects of primary disease status and timing of amputation on mortality.
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    Early period hospital mortality after orthopedic surgery and affecting factors By:Beyaz, S (Beyaz, Salih)[ 1 ]
    (2019) Beyaz, Salih; 000-0002-5788-5116; M-2609-2013
    Purpose: The aim of this study was to determine the factors affecting the mortality and the orthopedic surgical procedure with the highest hospital mortality. Materials and Methods: 19,727 patients who had undergone orthopedic surgery between 1998-2016 were included in the study. Of these patients, 370 patients who died in the hospital within the first 30 days were screened. Surgical procedures for patients with a higher than average mortality, age, gender, presence of malignancy, history of coronary artery disease, diabetes, hemodialysis, cerebrovascular event history, presence of hypertension, The American Society of Anesthesiologists (ASA) assessment score and anesthesia patterns were recorded. Results: Of 19,727 patients undergoing orthopedic surgery, 237 (1.23%) patients died early in the hospital after surgery. 4 surgical procedures with the highest mortality rate; It was found 6.35% in amputation surgery, 5.2% in femoral neck fracture, 4.2% in intertrochanteric hip fracture and 2.6% in vertabra surgery. Factors affecting the mortality were age, male gender, hypertension, having general anesthesia, having amputation surgery and having hemodialysis. ASA score was statistically significant in mortality all surgical types. Conclusion: Amputation is the most deadly orthopedic surgery in the early period. comorbid chronic diseases are the most important factors affecting mortality in orthopedic surgery.