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KMID : 0386720030150020162
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Journal of the Korean Hip Society
2003 Volume.15 No. 2 p.162 ~ p.166
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Value of Total Lymphocyte Counts as a Prognostic Index after Bipolar
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Yang Ick-Hwan
Han Chang-Dong
Kim HH
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Abstract
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Purpose: Total Lymphocyte Counts (TLCs) are now generally accepted as evidence of pre-existing malnutrition, and are used in other specialties to predict the prognosis following surgical intervention in the elderly. The high incidence of poor nutritional stati, in patients with femoral neck fractures, is well documented. The aim of this study was to assess the prognostic value of the total lymphocyte count in such patients for predicting early mortality and morbidity.
Patients and Methods: The records of 312 patients, with femoral neck fracture that underwent a bipolar hemiarthroplasty, between January 1992 and December 2001, were reviewed. 48 patients that died, or who were in intensive care for 2 weeks postoperative, were compared with 264 patients with complications resulting from TLCs and the serum albumin level, age, sex and body weight.
Results: The most frequent cause of death or complications was pneumonia. The mean TLC of the patients that died, of who had complications, was significantly lower than in the other group. Of those that died, or who had complications, 34 (70.8%) had subnormal TLCs, compared with the 99 patients (37.5%) with no complications. Of the 133 patients with subnormal TLCs, the 34 (25.6%) that died, or who had complications, were compared with 14 (7.8%) of the 179 patients with normal TLCs.
Conclusion: The total Lymphocyte Count is a prognostic index for the mortality or morbidity of the elderly, with femoral neck fractures, having undergone a bipolar hemiarthroplasty. Extra vigilance and early treatment may help to reduce the mortality in these patients.
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KEYWORD
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Femoral neck fracture, Bipolar hemiarthroplasty, Elderly, Total Lymphocyte Counts, Prognosis
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