Metabolic shock in elderly pertrochanteric or intertrochanteric surgery. Comparison of three surgical methods. Is there a much safer?
, , , , , , , , , und | 31. Dez. 2020
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Article Category: Original Paper
Online veröffentlicht: 31. Dez. 2020
Seitenbereich: 17 - 26
DOI: https://doi.org/10.2478/rjaic-2020-0016
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© 2020 David Gómez-Garrido et al. published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Trend of procalcitonin changes (n.v. <0.05 ng/ML) during 1 year of follow-up in the three groups.
| Time | Average procalcitonin (ng/mL) RIMN | Average procalcitonin (ng/mL) UINM | Average procalcitonin (ng/mL)DHS |
|---|---|---|---|
| 0 | 0.01 | 0.01 | 0.01 |
| Before surgery | 0.03 | 0.04 | 0.05 |
| After surgery | 0.50 | 0.50 | 0.50 |
| 1st month | 0.02 | 0.01 | 0.02 |
| 3rd month | 0.01 | 0.01 | 0.01 |
| 6th month | 0.02 | 0.01 | 0.01 |
| 12th month | 0.01 | 0.01 | 0.02 |
Description of population
| RIMN | UINM | DHS | |
|---|---|---|---|
| Numbers | 15 | 15 | 13 |
| Average age (years) | 83.5 | 84.9 | 82.4 |
| Range of age (years) | 75-100 | 75-102 | 75-96 |
| Sex | 12 M; 18 F | 11 M; 12 F | 8 M; 18 F |
| Antiplatelet used for thromboembolic prophylaxis | Enoxaparin: 15 | Enoxaparin: 15 | Enoxaparin: 13 |
| Average score of thromboembolic risk according to card TVP Tuscany Region | 5,7 | 5,9 | 5,5 |
| Anesthetic risk (ASA) | III | III | III |
| Number of patients on therapy for osteoporosis before trauma | 21 | 22 | 19 |
| Average time of surgery (min) | 23.6 | 18.6 | 45.3 |
| Length of surgical wound (cm) | 9.3 | 9.2 | 12.2 |
Trend of D-dimer changes (n.v. 50-500 ng/mL) during 1 year of follow-up in the three groups.
| Time | Average D-dimer (ng/mL) RIMN | Average D-dimer (ng/mL) UINM | Average D-dimer (ng/mL)DHS |
|---|---|---|---|
| 0 | 724.3 | 726.9 | 727.5 |
| Before surgery | 798.3 | 795.4 | 789.6 |
| After surgery | 803.5 | 804.7 | 808.3 |
| 1st month | 526.3 | 528.4 | 630.3 |
| 3rd month | 182.4 | 180.3 | 184.2 |
| 6th month | 78.3 | 79.5 | 80.5 |
| 12th month | 77.3 | 78.8 | 79.5 |
Comorbidities in the three investigated groups.
| Comorbidity | RIMN | UIMN | DHS |
|---|---|---|---|
| Cardiovascular disease | 6 | 7 | 6 |
| Stroke | 4 | 3 | 2 |
| Respiratory disease | 6 | 8 | 5 |
| Renal disease | 8 | 6 | 5 |
| Diabetes mellitus | 4 | 5 | 3 |
| Rheumatoid disease | 2 | 1 | 2 |
| Parkinson’s disease | 1 | 2 | 1 |
| Severe mental deterioration in old age | 8 | 8 | 5 |
| Paget’s disease | 1 | 1 | 0 |
| Current smokers | 5 | 4 | 2 |
| 1 | 5 (16.67%) | 4 (15.33%) | 4 (15.38%) |
| 2 | 10 (33.33%) | 11 (30.67%) | 8 (30.76%) |
| ≥3 | 15 (50%) | 15 (50%) | 14 (53.86%) |
Trend of LDH changes (n.v. 0-600 U/L) during 1 year of follow-up in the three groups.
| Time | Average LDH (U/L) RIMN | Average LDH (U/L) UIMN | Average LDH (U/L) DHS |
|---|---|---|---|
| 0 | 787.3 | 786.2 | 788.1 |
| Before surgery | 370.5 | 376.3 | 368.8 |
| After surgery | 701.2 | 702.3 | 929.5 |
| 1st month | 326.5 | 327.3 | 338.9 |
| 3rd month | 250.6 | 284.4 | 256.7 |
| 6th month | 232.5 | 237.9 | 236.4 |
| 12th month | 372.6 | 377.1 | 382.3 |
Trend of IL-1β changes (n.v.<1pg/mL) during 1 year of follow-up in the three groups.
| Time | Average IL-1β (pg/mL) RIMN | Average IL-1β (pg/mL) UINM | Average IL-1β (pg/mL) DHS |
|---|---|---|---|
| 0 | 2.1 | 2.3 | 2.1 |
| Before surgery | 2.3 | 2.6 | 2.4 |
| After surgery | 3.8 | 3.9 | 4.4 |
| 1st month | 2.7 | 2.7 | 3.1 |
| 3rd month | 1.8 | 1.9 | 2.9 |
| 6th month | 1.6 | 1.4 | 1.5 |
| 12th month | 1.7 | 1.7 | 1.6 |
Trend of IL-8 changes (n.v.<11 pg/mL) during 1 year of follow-up in the three groups.
| Time | Average IL-8 (pg/mL) RIMN | Average IL-8 (pg/mL) UINM | Average IL-8 (pg/mL) DHS |
|---|---|---|---|
| 0 | 18.3 | 17.6 | 16.9 |
| Before surgery | 24.5 | 23.3 | 22.5 |
| After surgery | 38.3 | 28.3 | 46.4 |
| 1st month | 33.4 | 24.5 | 28.8 |
| 3rd month | 24.5 | 23.3 | 27.6 |
| 6th month | 16.6 | 14.8 | 17.8 |
| 12th month | 13.2 | 13.3 | 14.2 |
Trend of alpha-1-acid glycoprotein changes (n.v. 55-120 mg/dL) during 1 year of follow-up in the three groups.
| Time | Average alpha-1-acid glycoprotein (mg/dL) RIMN | Average alpha-1-acid glycoprotein (mg/dL) UINM | Average alpha-1-acid glycoprotein (mg/dL) DHS |
|---|---|---|---|
| 0 | 237.5 | 245.6 | 248.2 |
| Before surgery | 280.2 | 288.5 | 274.6 |
| After surgery | 296.3 | 289.1 | 303.4 |
| 1st month | 184.4 | 168.7 | 209.1 |
| 3rd month | 156.8 | 148.9 | 178.2 |
| 6th month | 193.8 | 198.1 | 199.2 |
| 12th month | 181.4 | 182.6 | 185.7 |
Trend of CPK changes (n.v 60-190 U/L) during 1 year of follow-up in the three groups.
| Time | Average CPK (U/L) RIMN | Average CPK (U/L) UIMN | Average DHS CPK (U/L) |
|---|---|---|---|
| 0 | 308.7 | 315.5 | 299.8 |
| Before surgery | 270.3 | 271.8 | 268.3 |
| After surgery | 388.3 | 368.2 | 408.2 |
| 1st month | 202.3 | 198.3 | 199.4 |
| 3rd month | 199.7 | 197.3 | 198.2 |
| 6th month | 163.3 | 168.3 | 172.4 |
| 12th month | 102.3 | 106.4 | 105.3 |
Trend of ESR changes (n.v. fino a 10 mm/h) during 1 year of follow-up in the three groups.
| Time | Average ESR (mm/h) RIMN | Average ESR (mm/h) UINM | Average ESR (mm/h) DHS |
|---|---|---|---|
| 0 | 54.2 | 56.3 | 55.2 |
| Before surgery | 64.3 | 68.4 | 64.9 |
| After surgery | 78.3 | 78.5 | 77.2 |
| 1st month | 20.4 | 19.5 | 21.8 |
| 3rd month | 16.3 | 17.8 | 20.3 |
| 6th month | 12.3 | 11.8 | 12.2 |
| 12th month | 11.9 | 12.3 | 11.4 |
Trend of fibrinogen changes (n.v. 200-400 mg/dL) during 1 year of follow-up in the three groups.
| Time | Average fibrinogen (mg/dL) RIMN | Average fibrinogen (mg/dL) UINM | Average fibrinogen (mg/dL) DHS |
|---|---|---|---|
| 0 | 670.3 | 668.3 | 667.4 |
| Before surgery | 653.9 | 651.3 | 652.8 |
| After surgery | 710.3 | 711.3 | 708.9 |
| 1st month | 458.3 | 459.4 | 600.5 |
| 3rd month | 234.2 | 233.4 | 236.4 |
| 6th month | 202.4 | 202.5 | 207.4 |
| 12th month | 223.6 | 237.4 | 238.5 |
Trend of CRP changes (n.v.<5 mg/dL) during 1 year of follow-up in the three groups.
| Time | Average CRP (mg/dL) RIMN | Average CRP (mg/dL) UINM | Average CRP (mg/dL) DHS |
|---|---|---|---|
| 0 | 25.8 | 26.3 | 23.3 |
| Before surgery | 45.8 | 45.4 | 43.2 |
| After surgery | 59.5 | 59.3 | 51.8 |
| 1st month | 12.1 | 12.8 | 12.2 |
| 3rd month | 8.5 | 8.3 | 7.6 |
| 6th month | 6.1 | 6.3 | 5.9 |
| 12th month | 5.6 | 5.4 | 5.8 |
Trend of mortality during 1 year of follow-up in the three groups.
| Time | Mortality RIMN | Mortality UINM | Mortality DHS |
|---|---|---|---|
| 0 | 0 | 0 | 0 |
| Before surgery | 0 | 0 | 0 |
| After surgery | 0 | 0 | 1 |
| 1st month | 2 | 1 | 4 |
| 3rd month | 3 | 3 | 2 |
| 6th month | 1 | 2 | 2 |
| 12th month | 2 | 1 | 0 |
| Total | 8 (26.67%) | 7 (23.33) | 9 (34.61) |
Trend of IL-6 changes (n.v.<1.4pg/mL) during 1 year of follow-up in the three groups.
| Time | Average IL-6 (pg/mL) RIMN | AverageIL-6 (pg/mL) UINM | AverageIL-6 (pg/mL) DHS |
|---|---|---|---|
| 0 | 4.5 | 4.6 | 4.5 |
| Before surgery | 3.8 | 4.2 | 4.4 |
| After surgery | 6.5 | 5.6 | 6.7 |
| 1st month | 2.4 | 2.9 | 4.4 |
| 3rd month | 2.3 | 2.2 | 4.2 |
| 6th month | 1.9 | 1.6 | 1.8 |
| 12th month | 1.8 | 1.6 | 1.8 |