Turkiye Klinikleri Journal of Anesthesiology Reanimation

.: ORIGINAL RESEARCH
COVID-19 Enfeksiyonunun Geriatrik Kalça Kırığı Olan Hastalarda Postoperatif Erken Dönem Ağrı Üzerine Etkisi: Retrospektif Kohort Çalışma
Effect of COVID-19 Infection on Postoperative Early-Period Pain in Patients with Geriatric Hip Fracture: Retrospective Cohort Study
Süheyla KARADAĞ ERKOÇa, Mehmet Can GEZERb, Volkan BAYTAŞa, Mahmut KALEMb
aAnkara Üniversitesi Tıp Fakültesi, Anestezi ve Reanimasyon ABD, Ankara, Türkiye
bAnkara Üniversitesi Tıp Fakültesi, Ortopedi ve Travmatoloji ABD, Ankara, Türkiye
Turkiye Klinikleri J Anest Reanim. 2022;20(2):64-71
doi: 10.5336/anesthe.2022-91658
Article Language: TR
Full Text
ÖZET
 Amaç: Kalça kırıkları; geriatrik hastalarda genellikle düşük enerjili travma sonucu oluşan, yaşlının tüm fizyolojisini ve yaşam kalitesini olumsuz etkileyerek yüksek mortalite oranları ile seyreden kendine özgü ciddi bir kırık çeşididir. Kliniği daha da komplike hâle getiren koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)] pandemisinden etkilenen hastalarda ciddi ağrı oluşur ve kronik ağrı sendromuna neden olabilir. Bu çalışmanın amacı, kalça kırığı olan geriatrik hastalarda COVID-19 enfeksiyonunun ağrının nitelik ve niceliğine etkisini araştırmaktır. Gereç ve Yöntemler: Mart 2019-Mart 2020 tarihleri arasında Ankara Üniversitesi Tıp Fakültesi İbni Sina Hastanesinde, trokanterik kırık cerrahisi uygulanan 26 geriatrik hasta retrospektif olarak değerlendirildi. Hastalar, şiddetli akut solunum sendromu-koronavirüs-2 pozitif (Grup-C) ve negatif (Grup- N) olarak 2 gruba ayrıldı. Ameliyat sonrası ağrı, kısa McGill-Melzack ağrı soru formu (K-MASF) ve Vizüel Analog Skala (VAS) ile değerlendirildi. Hastalar ilk 12 ayda mortalite açısından takip edildi. Bulgular: Grup-C'de 10 hasta ve Grup-N'de 16 hasta değerlendirildi. Grup-C'de ortalama duyusal ağrı skoru 26,3±4,5 ve Grup-N'de 20±8,1 idi (p=0,01). Emosyonel ağrı şiddeti skoru Grup-C'de 9,3±2,0 ve Grup-N'de 6,1±2,8 idi (p=0,005). VAS ile ağrı şiddeti Grup-C'de 7,5±2,2 ve Grup-N'de 5±2,4 idi (p=0,01). On iki aylık takipteki mortalite oranı %26,9'du ve bu hastalarda K-MASF ve VAS skorları daha yüksekti (p<0,05). Sonuç: COVID-19 pozitif olan hastalarda ağrı niceliği ve niteliğinin, negatif olan hastalara göre daha yüksek olduğu görüldü. Postoperatif ağrıya bağlı komplikasyonları önlemek için standart analjezik tedaviler dışında etkili tedavi yöntemleri oluşturulmalıdır.

Anahtar Kelimeler: COVID-19; ağrı; geriatri; kalça kırıkları
ABSTRACT
 Objective: Hip fractures are a unique serious fracture type that usually occurs as a result of low-energy trauma in geriatric patients, adversely affects the entire physiology and quality of life of the elderly and progresses with high mortality rates. In patients affected by the coronavirus disease-2019 (COVID-19) pandemic, which further complicated the clinic, severe pain occurs and can cause chronic pain syndrome. The aim of this study was to investigate the effect of COVID-19 infection on the quality and quantity of pain in geriatric patients with hip fractures. Material and Methods: Twenty-six geriatric patients undergoing trochanteric fracture surgery between March 2019 and March 2020 at Ankara University Faculty of Medicine İbni Sina Hospital were evaluated retrospectively. Patients were divided into 2 groups as severe acute respiratory syndrome-coronavirus-2 positive (Group-C) and negative (Group-N). Postoperative pain was evaluated with Short-form McGill pain questionnaire (SF-MPQ), and Visual Analog Scale (VAS). Patients were followed up in terms of mortality in the first 12 months. Results: Ten patients in Group-C and 16 patients in Group- N were evaluated. The mean sensory pain score was 26.3±4.5 in Group-C and 20±8.1 in Group-N (p=0.01). The emotional pain intensity score was 9.3±2.0 in Group-C and 6.1±2.8 in Group-N (p=0.005). VAS was 7.5±2.2 in Group-C and 5±2.4 in Group-N (p=0.01). The mortality rate was 26.9% at 12-month follow-up and the SF-MPQ and VAS scores of these patients were higher (p<0.05). Conclusion: The quantity and quality of pain was higher in patients who were positive for COVID-19 than in patients who were negative. In order to prevent complications related to postoperative pain, effective treatment methods other than standard analgesic therapies should be established.

Keywords: COVID-19; pain; geriatrics; hip fractures
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