Estado inmunológico de ancianos candidatos a artroplastia tras fractura subcapital de cadera: estudio de su relación con la edad y con la morbimortalidad postoperatoria* / Immunological status of elderly patients eligible for arthroplasty after a femoral neck fracture: relationship between the patients' status, their age and postoperative morbimortality

ABSTRACT

Purpose. To analyze the relationship between a patient's immunological status prior to arthroplasty secondary to a femoral neck fracture and postoperative complications. Materials and methods. Prospective randomized study of 94 patients (81 of which female) with a Garden IV femoral neck fracture (mean age: 82.9 years (± 7.48), range: 100-64). On admission, the following parameters were evaluated in the patients' peripheral venous blood: differential leukocyte count; inmunoglobulin (IgG, IgA, IgM and IgE); percentage of CD19, CD3, CD4 and CD8; transferrin levels; alfa-2-macroglobulin; ceruloplasmin; retinol transport protein; prealbumin; albumin; total proteins; total cholesterol and triglycerides. Postoperative complications were studied. Statistics: Variance and chi square analysis. Results. There were twelve cases of surgical wound infection, 27 of urinary infection, 3 cases of pneumonia and one periprosthetic infection. Patients with a postoperative infection had lower preop levels of IgM (urinary infection and pneumonia), IgA (pneumonia) and IgE (wound infection), as well as a lower count of CD4 and CD8 per cubic mm (urinary infection and pneumonia) and a lower percentage of CD19 (wound infection). Albumin, prealbumin, total cholesterol, triglycerides and transferrin decreased significantly with age. Conclusions. The IgM, IgA, IgE, the CD19 percentage and CD4 and CD8 counts could be used indicators of a higher risk of developing infections after surgery for a femoral neck fracture (AU)