Endoscopic Retrograde Cholangiopancreatography in Nonagenarian Patients: Is It Really Safe?
Background/Aims: Literature on the safety of endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients is divided. Based on this we decided to examine the safety of ERCP in nonagenarian patients. Methods: A total of 1,389 patients, with a mean age of 63.94±19.62 years, underwent ERCP...
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| Veröffentlicht in: | Clinical endoscopy 2018-07, Vol.51 (4), p.375 |
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| creator | Zain A Sobani Daria Yunina Anna Abbasi Kevin Tin Daniel Simkin Mary Rojas Yuriy Tsirlin Ira Mayer Rabin Rahmani |
| description | Background/Aims: Literature on the safety of endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients is divided. Based on this we decided to examine the safety of ERCP in nonagenarian patients.
Methods: A total of 1,389 patients, with a mean age of 63.94±19.62 years, underwent ERCP during the study period. There were 74 patients aged 90 years or older with a mean age of 92.07±1.8. Logistic regression showed that nonagenarian patients had a significantly increased odds of in-patient mortality (adjusted odds ratio [AOR]=9.6; 95% confidence interval [CI]=4, 23; p≤0.001). Charlson Comorbidity Index (CCI) ≥2 was also an independent predictor of in-patient mortality (AOR=2.4; 95% CI=1.2, 5.2; p=0.021). Age ≥90 was not associated with increased adverse events; however emergency procedures (AOR=2.4; 95% CI=1.5, 4; p |
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Methods: A total of 1,389 patients, with a mean age of 63.94±19.62 years, underwent ERCP during the study period. There were 74 patients aged 90 years or older with a mean age of 92.07±1.8. Logistic regression showed that nonagenarian patients had a significantly increased odds of in-patient mortality (adjusted odds ratio [AOR]=9.6; 95% confidence interval [CI]=4, 23; p≤0.001). Charlson Comorbidity Index (CCI) ≥2 was also an independent predictor of in-patient mortality (AOR=2.4; 95% CI=1.2, 5.2; p=0.021). Age ≥90 was not associated with increased adverse events; however emergency procedures (AOR=2.4; 95% CI=1.5, 4; p<0.001) and CCI ≥2 (AOR=2.6; 95% CI=1.7, 4.0; p<0.001) were more likely to have adverse events.
Conclusions: Age ≥90 and CCI ≥2 are independently associated with increased odds of in-patient mortality in patients undergoing ERCP, whereas emergency procedures and CCI ≥2 are associated with an increased adverse event rate. Caution must be exercised when considering ERCP in patients aged ≥90 years and those with a CCI ≥2. Clin Endosc 2018;51:375-380</description><identifier>ISSN: 2234-2400</identifier><language>kor</language><publisher>대한소화기내시경학회</publisher><subject>80 and over ; Aged ; Cholangiopancreatography ; endoscopic retrograde</subject><ispartof>Clinical endoscopy, 2018-07, Vol.51 (4), p.375</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784</link.rule.ids></links><search><creatorcontrib>Zain A Sobani</creatorcontrib><creatorcontrib>Daria Yunina</creatorcontrib><creatorcontrib>Anna Abbasi</creatorcontrib><creatorcontrib>Kevin Tin</creatorcontrib><creatorcontrib>Daniel Simkin</creatorcontrib><creatorcontrib>Mary Rojas</creatorcontrib><creatorcontrib>Yuriy Tsirlin</creatorcontrib><creatorcontrib>Ira Mayer</creatorcontrib><creatorcontrib>Rabin Rahmani</creatorcontrib><title>Endoscopic Retrograde Cholangiopancreatography in Nonagenarian Patients: Is It Really Safe?</title><title>Clinical endoscopy</title><addtitle>Clinical Endoscopy</addtitle><description>Background/Aims: Literature on the safety of endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients is divided. Based on this we decided to examine the safety of ERCP in nonagenarian patients.
Methods: A total of 1,389 patients, with a mean age of 63.94±19.62 years, underwent ERCP during the study period. There were 74 patients aged 90 years or older with a mean age of 92.07±1.8. Logistic regression showed that nonagenarian patients had a significantly increased odds of in-patient mortality (adjusted odds ratio [AOR]=9.6; 95% confidence interval [CI]=4, 23; p≤0.001). Charlson Comorbidity Index (CCI) ≥2 was also an independent predictor of in-patient mortality (AOR=2.4; 95% CI=1.2, 5.2; p=0.021). Age ≥90 was not associated with increased adverse events; however emergency procedures (AOR=2.4; 95% CI=1.5, 4; p<0.001) and CCI ≥2 (AOR=2.6; 95% CI=1.7, 4.0; p<0.001) were more likely to have adverse events.
Conclusions: Age ≥90 and CCI ≥2 are independently associated with increased odds of in-patient mortality in patients undergoing ERCP, whereas emergency procedures and CCI ≥2 are associated with an increased adverse event rate. Caution must be exercised when considering ERCP in patients aged ≥90 years and those with a CCI ≥2. Clin Endosc 2018;51:375-380</description><subject>80 and over</subject><subject>Aged</subject><subject>Cholangiopancreatography</subject><subject>endoscopic retrograde</subject><issn>2234-2400</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp9jLEKwjAUADMoWLRf4PJ-oBCTEMHFoVTsIqJuDuXZpm0wJiHJ0r9Xwdnp4A5uRjLGuCiYoHRB8hj1gwqx5XwjaUbule1cbJ3XLVxUCm4I2CkoR2fQDtp5tG1QmL7ejxNoCydncVAWg0YLZ0xa2RR3UEeo0-eBxkxwxV7tV2Teo4kq_3FJ1ofqVh6Lp46x8UG_MEwNl2xDpeT_6xuUDj1_</recordid><startdate>20180730</startdate><enddate>20180730</enddate><creator>Zain A Sobani</creator><creator>Daria Yunina</creator><creator>Anna Abbasi</creator><creator>Kevin Tin</creator><creator>Daniel Simkin</creator><creator>Mary Rojas</creator><creator>Yuriy Tsirlin</creator><creator>Ira Mayer</creator><creator>Rabin Rahmani</creator><general>대한소화기내시경학회</general><scope>HZB</scope><scope>Q5X</scope></search><sort><creationdate>20180730</creationdate><title>Endoscopic Retrograde Cholangiopancreatography in Nonagenarian Patients: Is It Really Safe?</title><author>Zain A Sobani ; Daria Yunina ; Anna Abbasi ; Kevin Tin ; Daniel Simkin ; Mary Rojas ; Yuriy Tsirlin ; Ira Mayer ; Rabin Rahmani</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-kiss_primary_36210663</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>kor</language><creationdate>2018</creationdate><topic>80 and over</topic><topic>Aged</topic><topic>Cholangiopancreatography</topic><topic>endoscopic retrograde</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zain A Sobani</creatorcontrib><creatorcontrib>Daria Yunina</creatorcontrib><creatorcontrib>Anna Abbasi</creatorcontrib><creatorcontrib>Kevin Tin</creatorcontrib><creatorcontrib>Daniel Simkin</creatorcontrib><creatorcontrib>Mary Rojas</creatorcontrib><creatorcontrib>Yuriy Tsirlin</creatorcontrib><creatorcontrib>Ira Mayer</creatorcontrib><creatorcontrib>Rabin Rahmani</creatorcontrib><collection>KISS(한국학술정보)</collection><collection>Korean Studies Information Service System (KISS) B-Type</collection><jtitle>Clinical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zain A Sobani</au><au>Daria Yunina</au><au>Anna Abbasi</au><au>Kevin Tin</au><au>Daniel Simkin</au><au>Mary Rojas</au><au>Yuriy Tsirlin</au><au>Ira Mayer</au><au>Rabin Rahmani</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Endoscopic Retrograde Cholangiopancreatography in Nonagenarian Patients: Is It Really Safe?</atitle><jtitle>Clinical endoscopy</jtitle><addtitle>Clinical Endoscopy</addtitle><date>2018-07-30</date><risdate>2018</risdate><volume>51</volume><issue>4</issue><spage>375</spage><pages>375-</pages><issn>2234-2400</issn><abstract>Background/Aims: Literature on the safety of endoscopic retrograde cholangiopancreatography (ERCP) in elderly patients is divided. Based on this we decided to examine the safety of ERCP in nonagenarian patients.
Methods: A total of 1,389 patients, with a mean age of 63.94±19.62 years, underwent ERCP during the study period. There were 74 patients aged 90 years or older with a mean age of 92.07±1.8. Logistic regression showed that nonagenarian patients had a significantly increased odds of in-patient mortality (adjusted odds ratio [AOR]=9.6; 95% confidence interval [CI]=4, 23; p≤0.001). Charlson Comorbidity Index (CCI) ≥2 was also an independent predictor of in-patient mortality (AOR=2.4; 95% CI=1.2, 5.2; p=0.021). Age ≥90 was not associated with increased adverse events; however emergency procedures (AOR=2.4; 95% CI=1.5, 4; p<0.001) and CCI ≥2 (AOR=2.6; 95% CI=1.7, 4.0; p<0.001) were more likely to have adverse events.
Conclusions: Age ≥90 and CCI ≥2 are independently associated with increased odds of in-patient mortality in patients undergoing ERCP, whereas emergency procedures and CCI ≥2 are associated with an increased adverse event rate. Caution must be exercised when considering ERCP in patients aged ≥90 years and those with a CCI ≥2. Clin Endosc 2018;51:375-380</abstract><pub>대한소화기내시경학회</pub><tpages>6</tpages></addata></record> |
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| ispartof | Clinical endoscopy, 2018-07, Vol.51 (4), p.375 |
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| source | KoreaMed Synapse (Open Access); PubMed Central Open Access; KoreaMed Open Access; DOAJ Directory of Open Access Journals; PubMed Central |
| subjects | 80 and over Aged Cholangiopancreatography endoscopic retrograde |
| title | Endoscopic Retrograde Cholangiopancreatography in Nonagenarian Patients: Is It Really Safe? |
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