KMID : 1038120180510040375
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Clinical Endoscopy 2018 Volume.51 No. 4 p.375 ~ p.380
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Endoscopic Retrograde Cholangiopancreatography in Nonagenarian Patients: Is It Really Safe?
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Sobani Zain A
Yunina Daria Abbasi Anna A Tin Kevin Simkin Daniel Rojas Mary Tsirlin Yuriy Mayer Ira Rahmani Rabin
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Abstract
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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¡¾19.62 years, underwent ERCP during the study period. There were 74 patients aged 90 years or older with a mean age of 92.07¡¾1.8. 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¡Â0.001). Charlson Comorbidity Index (CCI) ¡Ã2 was also an independent predictor of in-patient mortality (AOR=2.4; 95% CI=1.2, 5.2; p=0.021). Age ¡Ã90 was not associated with increased adverse events; however emergency procedures (AOR=2.4; 95% CI=1.5, 4; p<0.001) and CCI ¡Ã2 (AOR=2.6; 95% CI=1.7, 4.0; p<0.001) were more likely to have adverse events.
Conclusions: Age ¡Ã90 and CCI ¡Ã2 are independently associated with increased odds of in-patient mortality in patients undergoing ERCP, whereas emergency procedures and CCI ¡Ã2 are associated with an increased adverse event rate. Caution must be exercised when considering ERCP in patients aged ¡Ã90 years and those with a CCI ¡Ã2.
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KEYWORD
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Cholangiopancreatography, endoscopic retrograde, Aged, 80 and over
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