Evaluation of Neutrophil-Lymphocyte Ratios According to Gupta Perioperative Myocardial Infarction or Cardiac Arrest (MICA) Risk Index in Elderly Patients Undergoing Hip Surgery

Authors : Bilge Banu TAŞDEMİR MECİT, Ali KAYNAK, Recep ALTIN, Elif DOĞAN BAKI, Özal ÖZCAN, Remziye SIVACI

Pages : 776-781

View : 69 | Download : 51

Publication Date : 2023-09-30

Article Type : Research Paper

Abstract :Background/Aims: Perioperative cardiac events are a leading cause of mortality after surgery. Consequently, risk stratification for perioperative myocardial ischemia and cardiac arrest has gained significant importance before surgery. The Gupta perioperative myocardial infarction or cardiac arrest insert ignore into journalissuearticles values(MICA); risk index provides a risk estimate for perioperative myocardial infarction or cardiac arrest. This study aimed to investigate the relationship between the MICA risk index and neutrophil-lymphocyte ratios insert ignore into journalissuearticles values(NLR); in elderly patients undergoing hip surgery. Methods: The medical records of patients operated on for hip fracture surgery between 01.10.2021 and 30.04.2022 were retrospectively analyzed. Demographic data, comorbidities, clinical and laboratory characteristics, Neutrophil-to-Lymphocyte Ratio insert ignore into journalissuearticles values(NLR);, and length of hospital stay were evaluated. Subsequently, MICA scores were computed. According to the MICA cardiac risk score, patients were categorized into two groups: a high-risk group insert ignore into journalissuearticles values(risk greater than 1%); and a low-risk group, and the preoperative NLR of these two groups was compared. Results: Results: The study included 83 patients aged 65 and older out of a total of 191 patients who underwent hip fracture surgery. The patients were assessed based on their MICA cardiac risk scores, and they were categorized into two groups: those with a MICA score<1 insert ignore into journalissuearticles values(n=30); and those with a MICA score≥1 insert ignore into journalissuearticles values(n=53);. Gender and body mass index insert ignore into journalissuearticles values(BMI); showed no significant differences between the groups. However, there were statistically significant variations observed in terms of age insert ignore into journalissuearticles values(p<0.001);, the American Society of Anaesthesiologists insert ignore into journalissuearticles values(ASA); classification insert ignore into journalissuearticles values(p<0.001);, and comorbidities insert ignore into journalissuearticles values(p=0.042);. Patients with a MICA score≥1 exhibited significant differences when compared to those with a MICA score<1 in terms of postoperative intensive care unit admission insert ignore into journalissuearticles values(p=0.003);, complication rate insert ignore into journalissuearticles values(p<0.001);, mortality insert ignore into journalissuearticles values(p=0.004);, and length of hospital stay insert ignore into journalissuearticles values(p=0.025);. Furthermore, there was a positive correlation between the MICA score and preoperative NLR insert ignore into journalissuearticles values(Neutrophil-to-Lymphocyte Ratio); insert ignore into journalissuearticles values(p=0.619, r=0.055);, although no significant difference was found between the two groups insert ignore into journalissuearticles values(p=0.486);. While the NLR was higher in patients with adverse outcomes insert ignore into journalissuearticles values(exitus); compared to those without, this difference did not reach statistical significance insert ignore into journalissuearticles values(p=0.165);. Conclusions: A comprehensive multidisciplinary approach is crucial for assessing preoperative risk factors and devising appropriate treatment strategies in elderly patients undergoing hip surgery. The MICA score can serve as a valuable tool for predicting perioperative risk in this patient population. Our study revealed no significant association between preoperative NLR and the MICA cardiac risk score.
Keywords : MICA skoru, kalça kırığı cerrahisi, NLR, perioperatif dönem, yaşlı hasta

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