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Short-term outcomes after pancreatoduodenectomy in octogenarians: multicentre case-control study.
Attard, Joseph A; Al-Sarireh, Bilal; Bhogal, Ricky Harminder; Farrugia, Alexia; Fusai, Giuseppe; Harper, Simon; Hidalgo-Salinas, Camila; Jah, Asif; Marangoni, Gabriele; Mortimer, Matthew; Pizanias, Michail; Prachialias, Andreas; Roberts, Keith J; Sew Hee, Chloe; Soggiu, Fiammetta; Srinivasan, Parthi; Chatzizacharias, Nikolaos A.
Afiliación
  • Attard JA; Hepatopancreatobiliary and Liver Transplant Unit, Queen Elizabeth Hospital, Birmingham, UK.
  • Al-Sarireh B; Department of Surgery, Morriston Hospital, Swansea, UK.
  • Bhogal RH; Hepatopancreatobiliary Unit, Royal Marsden Hospital, London, UK.
  • Farrugia A; Department of Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
  • Fusai G; Hepatopancreatobiliary and Liver Transplant Unit, Royal Free Hospital, London, UK.
  • Harper S; Hepatopancreatobiliary Unit, Cambridge University Hospital, Cambridge, UK.
  • Hidalgo-Salinas C; Hepatopancreatobiliary and Liver Transplant Unit, Royal Free Hospital, London, UK.
  • Jah A; Hepatopancreatobiliary Unit, Cambridge University Hospital, Cambridge, UK.
  • Marangoni G; Department of Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
  • Mortimer M; Department of Surgery, Morriston Hospital, Swansea, UK.
  • Pizanias M; Hepatopancreatobiliary Unit, King's College Hospital, London, UK.
  • Prachialias A; Hepatopancreatobiliary Unit, King's College Hospital, London, UK.
  • Roberts KJ; Hepatopancreatobiliary and Liver Transplant Unit, Queen Elizabeth Hospital, Birmingham, UK.
  • Sew Hee C; Hepatopancreatobiliary Unit, Cambridge University Hospital, Cambridge, UK.
  • Soggiu F; Hepatopancreatobiliary and Liver Transplant Unit, Royal Free Hospital, London, UK.
  • Srinivasan P; Hepatopancreatobiliary Unit, King's College Hospital, London, UK.
  • Chatzizacharias NA; Hepatopancreatobiliary and Liver Transplant Unit, Queen Elizabeth Hospital, Birmingham, UK.
Br J Surg ; 109(1): 89-95, 2021 12 17.
Article en En | MEDLINE | ID: mdl-34750618
BACKGROUND: Pancreatoduodenectomy (PD) is frequently the surgical treatment indicated for a number of pathologies. Elderly patients may be denied surgery because of concerns over poor perioperative outcomes. The aim of this study was to evaluate postoperative clinical outcomes and provide evidence on current UK practice in the elderly population after PD. METHODS: This was a multicentre retrospective case-control study of octogenarians undergoing PD between January 2008 and December 2017, matched with younger controls from seven specialist centres in the UK. The primary endpoint was 90-day mortality. Secondary endpoints were index admission mortality, postoperative complications, and 30-day readmission rates. RESULTS: In total, 235 octogenarians (median age 81 (range 80-90) years) and 235 controls (age 67 (31-79) years) were included in the study. Eastern Cooperative Oncology Group performance status (median 0 (range 0-3) versus 0 (0-2); P = 0.010) and Charlson Co-morbidity Index score (7 (6-11) versus 5 (2-9); P = 0.001) were higher for octogenarians than controls. Postoperative complication and 30-day readmission rates were comparable. The 90-day mortality rate was higher among octogenarians (9 versus 3 per cent; P = 0.030). Index admission mortality rates were comparable (4 versus 2 per cent; P = 0.160), indicating that the difference in mortality was related to deaths after hospital discharge. Despite the higher 90-day mortality rate in the octogenarian population, multivariable Cox regression analysis did not identify age as an independent predictor of postoperative mortality. CONCLUSION: Despite careful patient selection and comparable index admission mortality, 90-day and, particularly, out-of-hospital mortality rates were higher in octogenarians.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pancreaticoduodenectomía Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Br J Surg Año: 2021 Tipo del documento: Article Pais de publicación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pancreaticoduodenectomía Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: Br J Surg Año: 2021 Tipo del documento: Article Pais de publicación: Reino Unido