Kırılganlığın Total Eklem Artroplastisi Sonrası Erken Dönem Hasta Sonuçlarına Etkisinin Belirlenmesi

Abstract

This descriptive, prospective, and correlational study was conducted to determine the relationship between fraility status and early postoperative patient outcomes in patients undergoing elective total joint arthroplasty. The study was conducted on 170 patients who underwent primary, unilateral total joint arthroplasty at the Orthopedics and Traumatology Clinic of an university hospital in Ankara between March 2024 and March 2025. Data were collected using the “Identification and Medical Characteristics Form”, “Modified Charlson Comorbidity Index” and “FRAIL Scale”. In the analysis of the data, SPSS v23, IBM AMOS v24, and R 4.4.1 were used and comparative tests, correlation analyses, binary logistic regression and path analysis were performed. The p-value was considered statistically significant when it was less than 0.05 in the study. 45.3% of the patients were determined to be frail. The mean overall NRS score was determined to be 2.47±1,16, and a statistically significant association was found between frailty level and postoperative pain level (p<0,001). It was determined that the average time for the first mobilization of patients was 24.88±4.36 hours and a statistically significant difference was found between frail patients and time to first mobilization (p=0,036). It was found that the average length of hospital stay for patients was 3.38±1.11 days and a statistically significant association was found between frail patients and length of hospital stay (p<0.001). It was found that 32.9% of the patients experienced early postoperative problems, and the frequency of problems increased significantly as frailty levels increased (p<0.001). It is considered that frail patients should be regarded as a high-risk group in terms of early postoperative problems, pain, length of hospital stay, and time to first mobilization, and that nurses’ routine assessment of frailty levels using frailty assessment tools in the preoperative period will be guiding in planning the management of adverse patient outcomes in the early postoperative period.