Does Endoscopic Retrograde Cholangiopancreatography Carry Higher Risk for Patients 90 Years and Older? A Single-Institution Retrospective Study
BACKGROUND Endoscopic retrograde cholangiography (ERCP) for patients aged ≥90 years is often required. The safety of ERCP for super-elderly patients is a major concern for gastrointestinal endoscopists. We retrospectively examined the safety of ERCP for super-elderly patients by comparison with pati...
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| Veröffentlicht in: | Medical science monitor 2020-12, Vol.26, p.e928033-e928033 |
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| creator | Ogiwara, Shingo Furihata, Makoto Inami, Yoshihiro Okawa, Hiroki Nomoto, Yusuke Kitamura, Tsuneo Osada, Taro Nagahara, Akihito |
| description | BACKGROUND Endoscopic retrograde cholangiography (ERCP) for patients aged ≥90 years is often required. The safety of ERCP for super-elderly patients is a major concern for gastrointestinal endoscopists. We retrospectively examined the safety of ERCP for super-elderly patients by comparison with patients in their 70s. MATERIAL AND METHODS We reviewed 66 patients aged ≥90 years (Group A) and 43 patients in their 70s (Group B) who underwent ERCP in our institution from January 2012 to October 2019. Data were collected on patients' backgrounds, corresponding procedures, and clinical outcomes, including adverse events. RESULTS Patients in Group A (mean age: 92.3±2.1 years) had significantly poorer performance status (median: 3 vs. 0; P |
| doi_str_mv | 10.12659/MSM.928033 |
| format | Article |
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A Single-Institution Retrospective Study</title><source>PubMed Central (Open access)</source><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek</source><source>PubMed Central Open Access</source><creator>Ogiwara, Shingo ; Furihata, Makoto ; Inami, Yoshihiro ; Okawa, Hiroki ; Nomoto, Yusuke ; Kitamura, Tsuneo ; Osada, Taro ; Nagahara, Akihito</creator><creatorcontrib>Ogiwara, Shingo ; Furihata, Makoto ; Inami, Yoshihiro ; Okawa, Hiroki ; Nomoto, Yusuke ; Kitamura, Tsuneo ; Osada, Taro ; Nagahara, Akihito</creatorcontrib><description>BACKGROUND Endoscopic retrograde cholangiography (ERCP) for patients aged ≥90 years is often required. The safety of ERCP for super-elderly patients is a major concern for gastrointestinal endoscopists. We retrospectively examined the safety of ERCP for super-elderly patients by comparison with patients in their 70s. MATERIAL AND METHODS We reviewed 66 patients aged ≥90 years (Group A) and 43 patients in their 70s (Group B) who underwent ERCP in our institution from January 2012 to October 2019. Data were collected on patients' backgrounds, corresponding procedures, and clinical outcomes, including adverse events. RESULTS Patients in Group A (mean age: 92.3±2.1 years) had significantly poorer performance status (median: 3 vs. 0; P<0.001) and American Society of Anesthesiologists classification (median: III vs. II; P<0.001) when compared to Group B (mean age: 75.1±2.7 years). Underlying cardiovascular, cerebrovascular, renal, and orthopedic comorbidity occurrence was significantly higher in Group A than in Group B (87.88% vs. 67.44%; P=0.0094). Group A comprised more patients with benign disease than Group B (90.91% vs. 76.74%; P=0.040). Group B comprised more patients with malignant disease (31.82% vs. 53.54%; P=0.041). Emergency ERCP was higher in Group A than in Group B (71.70% vs. 29.73%; P<0.0001). No significant between-group differences in adverse events (15.15% vs. 11.63%; P=0.602) and mortality rate (1.52% vs. 2.33%; P=0.758) were noted. CONCLUSIONS Indications for ERCP should not be determined simply based on the super-elderly age of patients. ERCP may not necessarily carry higher risks if endoscopists practice maximal caution against gastrointestinal perforation.</description><identifier>ISSN: 1643-3750</identifier><identifier>ISSN: 1234-1010</identifier><identifier>EISSN: 1643-3750</identifier><identifier>DOI: 10.12659/MSM.928033</identifier><identifier>PMID: 33281183</identifier><language>eng</language><publisher>United States: International Scientific Literature, Inc</publisher><subject>Aged, 80 and over ; Cholangiopancreatography, Endoscopic Retrograde - adverse effects ; Database Analysis ; Female ; Humans ; Incidence ; Intestinal Perforation - etiology ; Male ; Retrospective Studies ; Risk Factors ; Treatment Outcome</subject><ispartof>Medical science monitor, 2020-12, Vol.26, p.e928033-e928033</ispartof><rights>Med Sci Monit, 2020 2020</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c509t-a4187a1264c5e5d77d23ec0ef6c7dae828ec8e6f1886288b56bea9663842dc293</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7731116/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7731116/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33281183$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ogiwara, Shingo</creatorcontrib><creatorcontrib>Furihata, Makoto</creatorcontrib><creatorcontrib>Inami, Yoshihiro</creatorcontrib><creatorcontrib>Okawa, Hiroki</creatorcontrib><creatorcontrib>Nomoto, Yusuke</creatorcontrib><creatorcontrib>Kitamura, Tsuneo</creatorcontrib><creatorcontrib>Osada, Taro</creatorcontrib><creatorcontrib>Nagahara, Akihito</creatorcontrib><title>Does Endoscopic Retrograde Cholangiopancreatography Carry Higher Risk for Patients 90 Years and Older? A Single-Institution Retrospective Study</title><title>Medical science monitor</title><addtitle>Med Sci Monit</addtitle><description>BACKGROUND Endoscopic retrograde cholangiography (ERCP) for patients aged ≥90 years is often required. The safety of ERCP for super-elderly patients is a major concern for gastrointestinal endoscopists. We retrospectively examined the safety of ERCP for super-elderly patients by comparison with patients in their 70s. MATERIAL AND METHODS We reviewed 66 patients aged ≥90 years (Group A) and 43 patients in their 70s (Group B) who underwent ERCP in our institution from January 2012 to October 2019. Data were collected on patients' backgrounds, corresponding procedures, and clinical outcomes, including adverse events. RESULTS Patients in Group A (mean age: 92.3±2.1 years) had significantly poorer performance status (median: 3 vs. 0; P<0.001) and American Society of Anesthesiologists classification (median: III vs. II; P<0.001) when compared to Group B (mean age: 75.1±2.7 years). Underlying cardiovascular, cerebrovascular, renal, and orthopedic comorbidity occurrence was significantly higher in Group A than in Group B (87.88% vs. 67.44%; P=0.0094). Group A comprised more patients with benign disease than Group B (90.91% vs. 76.74%; P=0.040). Group B comprised more patients with malignant disease (31.82% vs. 53.54%; P=0.041). Emergency ERCP was higher in Group A than in Group B (71.70% vs. 29.73%; P<0.0001). No significant between-group differences in adverse events (15.15% vs. 11.63%; P=0.602) and mortality rate (1.52% vs. 2.33%; P=0.758) were noted. CONCLUSIONS Indications for ERCP should not be determined simply based on the super-elderly age of patients. ERCP may not necessarily carry higher risks if endoscopists practice maximal caution against gastrointestinal perforation.</description><subject>Aged, 80 and over</subject><subject>Cholangiopancreatography, Endoscopic Retrograde - adverse effects</subject><subject>Database Analysis</subject><subject>Female</subject><subject>Humans</subject><subject>Incidence</subject><subject>Intestinal Perforation - etiology</subject><subject>Male</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Treatment Outcome</subject><issn>1643-3750</issn><issn>1234-1010</issn><issn>1643-3750</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVUU1P3DAQtapWfJ96r3ysVIX6I3GcSyu0QEECgVg49GR57UnWbdZObQdpfwV_uYEFBKcZzTy9eW8eQp8pOaRMVM33y_nlYcMk4fwD2qGi5AWvK_LxTb-NdlP6QwiTglRbaJtzJimVfAc9HAdI-MTbkEwYnME3kGPooraAZ8vQa9-5MGhvIuj8OB-WazzTMa7xmeuWEPGNS39xGyK-1tmBzwk3BP8GHRPW3uKr3kL8iY_w3Pmuh-Lcp-zymF3wm1tpAJPdPeB5Hu16H31qdZ_g4LnuobvTk9vZWXFx9et8dnRRmIo0udAllbWe7JemgsrWtWUcDIFWmNpqkEyCkSBaKqVgUi4qsQDdCMFlyaxhDd9DPza8w7hYgTWT8Kh7NUS30nGtgnbq_ca7perCvaprTikVE8HXZ4IY_o2Qslq5ZKCfPgZhTIqVopZl2QgyQb9toGZymyK0r2coUU8RqilCtYlwQn95q-wV-5IZ_w_T-5o9</recordid><startdate>20201207</startdate><enddate>20201207</enddate><creator>Ogiwara, Shingo</creator><creator>Furihata, Makoto</creator><creator>Inami, Yoshihiro</creator><creator>Okawa, Hiroki</creator><creator>Nomoto, Yusuke</creator><creator>Kitamura, Tsuneo</creator><creator>Osada, Taro</creator><creator>Nagahara, Akihito</creator><general>International Scientific Literature, Inc</general><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>20201207</creationdate><title>Does Endoscopic Retrograde Cholangiopancreatography Carry Higher Risk for Patients 90 Years and Older? A Single-Institution Retrospective Study</title><author>Ogiwara, Shingo ; Furihata, Makoto ; Inami, Yoshihiro ; Okawa, Hiroki ; Nomoto, Yusuke ; Kitamura, Tsuneo ; Osada, Taro ; Nagahara, Akihito</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c509t-a4187a1264c5e5d77d23ec0ef6c7dae828ec8e6f1886288b56bea9663842dc293</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Aged, 80 and over</topic><topic>Cholangiopancreatography, Endoscopic Retrograde - adverse effects</topic><topic>Database Analysis</topic><topic>Female</topic><topic>Humans</topic><topic>Incidence</topic><topic>Intestinal Perforation - etiology</topic><topic>Male</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Treatment Outcome</topic><toplevel>online_resources</toplevel><creatorcontrib>Ogiwara, Shingo</creatorcontrib><creatorcontrib>Furihata, Makoto</creatorcontrib><creatorcontrib>Inami, Yoshihiro</creatorcontrib><creatorcontrib>Okawa, Hiroki</creatorcontrib><creatorcontrib>Nomoto, Yusuke</creatorcontrib><creatorcontrib>Kitamura, Tsuneo</creatorcontrib><creatorcontrib>Osada, Taro</creatorcontrib><creatorcontrib>Nagahara, Akihito</creatorcontrib><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>Medical science monitor</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ogiwara, Shingo</au><au>Furihata, Makoto</au><au>Inami, Yoshihiro</au><au>Okawa, Hiroki</au><au>Nomoto, Yusuke</au><au>Kitamura, Tsuneo</au><au>Osada, Taro</au><au>Nagahara, Akihito</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Does Endoscopic Retrograde Cholangiopancreatography Carry Higher Risk for Patients 90 Years and Older? A Single-Institution Retrospective Study</atitle><jtitle>Medical science monitor</jtitle><addtitle>Med Sci Monit</addtitle><date>2020-12-07</date><risdate>2020</risdate><volume>26</volume><spage>e928033</spage><epage>e928033</epage><pages>e928033-e928033</pages><issn>1643-3750</issn><issn>1234-1010</issn><eissn>1643-3750</eissn><abstract>BACKGROUND Endoscopic retrograde cholangiography (ERCP) for patients aged ≥90 years is often required. The safety of ERCP for super-elderly patients is a major concern for gastrointestinal endoscopists. We retrospectively examined the safety of ERCP for super-elderly patients by comparison with patients in their 70s. MATERIAL AND METHODS We reviewed 66 patients aged ≥90 years (Group A) and 43 patients in their 70s (Group B) who underwent ERCP in our institution from January 2012 to October 2019. Data were collected on patients' backgrounds, corresponding procedures, and clinical outcomes, including adverse events. RESULTS Patients in Group A (mean age: 92.3±2.1 years) had significantly poorer performance status (median: 3 vs. 0; P<0.001) and American Society of Anesthesiologists classification (median: III vs. II; P<0.001) when compared to Group B (mean age: 75.1±2.7 years). Underlying cardiovascular, cerebrovascular, renal, and orthopedic comorbidity occurrence was significantly higher in Group A than in Group B (87.88% vs. 67.44%; P=0.0094). Group A comprised more patients with benign disease than Group B (90.91% vs. 76.74%; P=0.040). Group B comprised more patients with malignant disease (31.82% vs. 53.54%; P=0.041). Emergency ERCP was higher in Group A than in Group B (71.70% vs. 29.73%; P<0.0001). No significant between-group differences in adverse events (15.15% vs. 11.63%; P=0.602) and mortality rate (1.52% vs. 2.33%; P=0.758) were noted. CONCLUSIONS Indications for ERCP should not be determined simply based on the super-elderly age of patients. ERCP may not necessarily carry higher risks if endoscopists practice maximal caution against gastrointestinal perforation.</abstract><cop>United States</cop><pub>International Scientific Literature, Inc</pub><pmid>33281183</pmid><doi>10.12659/MSM.928033</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Aged, 80 and over Cholangiopancreatography, Endoscopic Retrograde - adverse effects Database Analysis Female Humans Incidence Intestinal Perforation - etiology Male Retrospective Studies Risk Factors Treatment Outcome |
| title | Does Endoscopic Retrograde Cholangiopancreatography Carry Higher Risk for Patients 90 Years and Older? A Single-Institution Retrospective Study |
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