- Journal of Contemporary Medicine
- Cilt: 13 Sayı: 5
- Evaluation of Neutrophil-Lymphocyte Ratios According to Gupta Perioperative Myocardial Infarction or...
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 Taşdemir Mecit, Ali Kaynak, Recep Altin, Elif Doğan Baki, Özal Özcan, Remziye Sivaci
Pages : 776-781
View : 41 | Download : 41
Publication Date : 2023-09-30
Article Type : Research
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 (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 (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 (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 (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 (n=30) and those with a MICA score≥1 (n=53). Gender and body mass index (BMI) showed no significant differences between the groups. However, there were statistically significant variations observed in terms of age (p<0.001), the American Society of Anaesthesiologists (ASA) classification (p<0.001), and comorbidities (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 (p=0.003), complication rate (p<0.001), mortality (p=0.004), and length of hospital stay (p=0.025). Furthermore, there was a positive correlation between the MICA score and preoperative NLR (Neutrophil-to-Lymphocyte Ratio) (p=0.619, r=0.055), although no significant difference was found between the two groups (p=0.486). While the NLR was higher in patients with adverse outcomes (exitus) compared to those without, this difference did not reach statistical significance (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