Pre- and intraoperative variables affecting early outcomes in elderly patients undergoing pancreaticoduodenectomy
Abstract Background Conflicting data exist regarding the safety of pancreatic resections in elderly patients. In this study we compared early complication and mortality rates between patients younger and older than 80 years of age who underwent pancreaticoduodenectomy using a validated national data...
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| Veröffentlicht in: | HPB (Oxford, England) England), 2011-12, Vol.13 (12), p.887-892 |
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| creator | de la Fuente, Sebastian G Bennett, Kyla M Pappas, Theodore N Scarborough, John E |
| description | Abstract Background Conflicting data exist regarding the safety of pancreatic resections in elderly patients. In this study we compared early complication and mortality rates between patients younger and older than 80 years of age who underwent pancreaticoduodenectomy using a validated national database. Methods The National Surgical Quality Improvement Program (NSQIP) database for 2005–2009 was used for this retrospective analysis. The primary outcome measures for our analysis were 30-day postoperative mortality, major complication rate and overall complication rate. Results A total of 6293 patients who underwent PD for any cause were included in the analysis. Of these, 9.4% were aged ≥80 years. The incidence of 30-day mortality was significantly higher in patients aged ≥80 years (6.3%) than in those aged |
| doi_str_mv | 10.1111/j.1477-2574.2011.00390.x |
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In this study we compared early complication and mortality rates between patients younger and older than 80 years of age who underwent pancreaticoduodenectomy using a validated national database. Methods The National Surgical Quality Improvement Program (NSQIP) database for 2005–2009 was used for this retrospective analysis. The primary outcome measures for our analysis were 30-day postoperative mortality, major complication rate and overall complication rate. Results A total of 6293 patients who underwent PD for any cause were included in the analysis. Of these, 9.4% were aged ≥80 years. The incidence of 30-day mortality was significantly higher in patients aged ≥80 years (6.3%) than in those aged <80 years (2.7%). Older patients were also noted to have higher rates of overall complications and serious complications. On multivariate analysis, age, ASA (American Society of Anesthesiologists) classification, reduced functional status, history of dyspnoea, and need for intraoperative transfusion were risk factors associated with the occurrence of overall complications, serious complications and postoperative mortality. Conclusions This study shows that age among other factors is a determinant of postoperative morbidity and mortality following PD.</description><identifier>ISSN: 1365-182X</identifier><identifier>EISSN: 1477-2574</identifier><identifier>DOI: 10.1111/j.1477-2574.2011.00390.x</identifier><identifier>PMID: 22081925</identifier><language>eng</language><publisher>Oxford, UK: Elsevier Ltd</publisher><subject>Activities of Daily Living ; Age Factors ; Aged ; Aged, 80 and over ; Chi-Square Distribution ; Databases as Topic ; elderly ; Female ; functional status ; Gastroenterology and Hepatology ; Geriatric Assessment ; Humans ; Logistic Models ; Male ; Odds Ratio ; Original ; pancreatic cancer ; pancreaticoduodenectomy ; Pancreaticoduodenectomy - adverse effects ; Pancreaticoduodenectomy - mortality ; Patient Selection ; Postoperative Complications - etiology ; Postoperative Complications - mortality ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome ; United States</subject><ispartof>HPB (Oxford, England), 2011-12, Vol.13 (12), p.887-892</ispartof><rights>International Hepato-Pancreato-Biliary Association</rights><rights>2011 International Hepato-Pancreato-Biliary Association</rights><rights>2011 International Hepato‐Pancreato‐Biliary Association</rights><rights>2011 International Hepato-Pancreato-Biliary Association.</rights><rights>Copyright © 2011 International Hepato-Pancreato-Biliary Association 2011</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c6900-9c6809d7ae3e0ceec74fb6004eeebf62be57e9da80f6daf658aec266f2bcca943</citedby><cites>FETCH-LOGICAL-c6900-9c6809d7ae3e0ceec74fb6004eeebf62be57e9da80f6daf658aec266f2bcca943</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3244629/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3244629/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,1417,27924,27925,45574,45575,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22081925$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>de la Fuente, Sebastian G</creatorcontrib><creatorcontrib>Bennett, Kyla M</creatorcontrib><creatorcontrib>Pappas, Theodore N</creatorcontrib><creatorcontrib>Scarborough, John E</creatorcontrib><title>Pre- and intraoperative variables affecting early outcomes in elderly patients undergoing pancreaticoduodenectomy</title><title>HPB (Oxford, England)</title><addtitle>HPB (Oxford)</addtitle><description>Abstract Background Conflicting data exist regarding the safety of pancreatic resections in elderly patients. In this study we compared early complication and mortality rates between patients younger and older than 80 years of age who underwent pancreaticoduodenectomy using a validated national database. Methods The National Surgical Quality Improvement Program (NSQIP) database for 2005–2009 was used for this retrospective analysis. The primary outcome measures for our analysis were 30-day postoperative mortality, major complication rate and overall complication rate. Results A total of 6293 patients who underwent PD for any cause were included in the analysis. Of these, 9.4% were aged ≥80 years. The incidence of 30-day mortality was significantly higher in patients aged ≥80 years (6.3%) than in those aged <80 years (2.7%). Older patients were also noted to have higher rates of overall complications and serious complications. On multivariate analysis, age, ASA (American Society of Anesthesiologists) classification, reduced functional status, history of dyspnoea, and need for intraoperative transfusion were risk factors associated with the occurrence of overall complications, serious complications and postoperative mortality. Conclusions This study shows that age among other factors is a determinant of postoperative morbidity and mortality following PD.</description><subject>Activities of Daily Living</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Chi-Square Distribution</subject><subject>Databases as Topic</subject><subject>elderly</subject><subject>Female</subject><subject>functional status</subject><subject>Gastroenterology and Hepatology</subject><subject>Geriatric Assessment</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Odds Ratio</subject><subject>Original</subject><subject>pancreatic cancer</subject><subject>pancreaticoduodenectomy</subject><subject>Pancreaticoduodenectomy - adverse effects</subject><subject>Pancreaticoduodenectomy - mortality</subject><subject>Patient Selection</subject><subject>Postoperative Complications - etiology</subject><subject>Postoperative Complications - mortality</subject><subject>Retrospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>United States</subject><issn>1365-182X</issn><issn>1477-2574</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkk9v1DAQxSMEoqXwFVBunBJsJ3FiCVViK9giVVDE39vIcSaLt1k7tZNl8-1xSFkBp_piy_Pes0e_iaKYkpSG9XKb0rwsE1aUecoIpSkhmSDp4UF0eiw8DOeMFwmt2PeT6In3W0IYJVQ8jk4YIxUVrDiNbq8dJrE0TazN4KTt0clB7zHeS6dl3aGPZduiGrTZxChdN8V2HJTdhYI2MXYNznd9MKEZfDyacLGxs7qXRjkMBWWb0TZoQordTU-jR63sPD6728-iL2_ffL64TK4-rN9dvL5KFBeEJELxioimlJghUYiqzNuaE5IjYt1yVmNRomhkRVreyJYXlUTFOG9ZrZQUeXYWnS-5_VjvsFE499dB7_ROugms1PBvxegfsLF7yFiecyZCwIu7AGdvR_QD7LRX2HXSoB09CJIzxmheBWW1KJWz3jtsj69QAjMw2MLMBWYuMAOD38DgEKzP__7l0fiHUBC8WgQ_dYfTvYPh8noVDsGeLHbtBzwc7dLdAC-zsoBv79dQfOSrr-tcwPzcatFjQLPX6MCrQFZho13gB43V92nq_L8Q1WmjlexucEK_taMzAT1Q8AwIfJrndB5TWmQkq8oy-wUXgeMJ</recordid><startdate>201112</startdate><enddate>201112</enddate><creator>de la Fuente, Sebastian G</creator><creator>Bennett, Kyla M</creator><creator>Pappas, Theodore N</creator><creator>Scarborough, John E</creator><general>Elsevier Ltd</general><general>Blackwell Publishing Ltd</general><scope>6I.</scope><scope>AAFTH</scope><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201112</creationdate><title>Pre- and intraoperative variables affecting early outcomes in elderly patients undergoing pancreaticoduodenectomy</title><author>de la Fuente, Sebastian G ; Bennett, Kyla M ; Pappas, Theodore N ; Scarborough, John E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c6900-9c6809d7ae3e0ceec74fb6004eeebf62be57e9da80f6daf658aec266f2bcca943</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Activities of Daily Living</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Chi-Square Distribution</topic><topic>Databases as Topic</topic><topic>elderly</topic><topic>Female</topic><topic>functional status</topic><topic>Gastroenterology and Hepatology</topic><topic>Geriatric Assessment</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Odds Ratio</topic><topic>Original</topic><topic>pancreatic cancer</topic><topic>pancreaticoduodenectomy</topic><topic>Pancreaticoduodenectomy - adverse effects</topic><topic>Pancreaticoduodenectomy - mortality</topic><topic>Patient Selection</topic><topic>Postoperative Complications - etiology</topic><topic>Postoperative Complications - mortality</topic><topic>Retrospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>United States</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>de la Fuente, Sebastian G</creatorcontrib><creatorcontrib>Bennett, Kyla M</creatorcontrib><creatorcontrib>Pappas, Theodore N</creatorcontrib><creatorcontrib>Scarborough, John E</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>HPB (Oxford, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>de la Fuente, Sebastian G</au><au>Bennett, Kyla M</au><au>Pappas, Theodore N</au><au>Scarborough, John E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pre- and intraoperative variables affecting early outcomes in elderly patients undergoing pancreaticoduodenectomy</atitle><jtitle>HPB (Oxford, England)</jtitle><addtitle>HPB (Oxford)</addtitle><date>2011-12</date><risdate>2011</risdate><volume>13</volume><issue>12</issue><spage>887</spage><epage>892</epage><pages>887-892</pages><issn>1365-182X</issn><eissn>1477-2574</eissn><abstract>Abstract Background Conflicting data exist regarding the safety of pancreatic resections in elderly patients. In this study we compared early complication and mortality rates between patients younger and older than 80 years of age who underwent pancreaticoduodenectomy using a validated national database. Methods The National Surgical Quality Improvement Program (NSQIP) database for 2005–2009 was used for this retrospective analysis. The primary outcome measures for our analysis were 30-day postoperative mortality, major complication rate and overall complication rate. Results A total of 6293 patients who underwent PD for any cause were included in the analysis. Of these, 9.4% were aged ≥80 years. The incidence of 30-day mortality was significantly higher in patients aged ≥80 years (6.3%) than in those aged <80 years (2.7%). Older patients were also noted to have higher rates of overall complications and serious complications. On multivariate analysis, age, ASA (American Society of Anesthesiologists) classification, reduced functional status, history of dyspnoea, and need for intraoperative transfusion were risk factors associated with the occurrence of overall complications, serious complications and postoperative mortality. Conclusions This study shows that age among other factors is a determinant of postoperative morbidity and mortality following PD.</abstract><cop>Oxford, UK</cop><pub>Elsevier Ltd</pub><pmid>22081925</pmid><doi>10.1111/j.1477-2574.2011.00390.x</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Activities of Daily Living Age Factors Aged Aged, 80 and over Chi-Square Distribution Databases as Topic elderly Female functional status Gastroenterology and Hepatology Geriatric Assessment Humans Logistic Models Male Odds Ratio Original pancreatic cancer pancreaticoduodenectomy Pancreaticoduodenectomy - adverse effects Pancreaticoduodenectomy - mortality Patient Selection Postoperative Complications - etiology Postoperative Complications - mortality Retrospective Studies Risk Assessment Risk Factors Time Factors Treatment Outcome United States |
| title | Pre- and intraoperative variables affecting early outcomes in elderly patients undergoing pancreaticoduodenectomy |
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