07 December 2020 : Database Analysis
Does Endoscopic Retrograde Cholangiopancreatography Carry Higher Risk for Patients 90 Years and Older? A Single-Institution Retrospective StudyShingo Ogiwara1ABCDEF*, Makoto Furihata1ABCDEF, Yoshihiro Inami2AD, Hiroki Okawa1B, Yusuke Nomoto1B, Tsuneo Kitamura1D, Taro Osada1DE, Akihito Nagahara3D
Med Sci Monit 2020; 26:e928033
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.
Keywords: Cholangiopancreatography, Endoscopic Retrograde, Comorbidity, Frail Elderly, Geriatrics, Mortality
27 September 2021 : EditorialEditorial: Global Regulatory Initiatives Deliver Accelerated Approval of the First Bispecific Therapeutic Monoclonal Antibody for Advanced Non-Small Cell Lung Cancer (NSCLC)
Med Sci Monit 2021; 27:e934854
08 September 2021 : Clinical ResearchAcceptance of COVID-19 Vaccination and Its Associated Factors Among Cancer Patients Attending the Oncology ...
Med Sci Monit In Press; DOI: 10.12659/MSM.932788
16 July 2021 : Review articleSilent Hypoxemia in Patients with COVID-19 Pneumonia: A Review
Med Sci Monit In Press; DOI: 10.12659/MSM.930776
09 July 2021 : Database AnalysisA Simple Clinical Prediction Tool for COVID-19 in Primary Care with Epidemiology: Temperature-Leukocytes-CT...
Med Sci Monit In Press; DOI: 10.12659/MSM.931467
27 Sep 2021 : Clinical ResearchEffect of Combined Thoracic Paravertebral Block and General Anesthesia vs General Anesthesia Alone on Posto...
Med Sci Monit In Press; DOI: 10.12659/MSM.933623
24 Sep 2021 : Clinical ResearchA Single-Center Study of a Resin Inlay Dental Implant-Fixed Prosthesis for Closing Proximal Contact Loss in...
Med Sci Monit In Press; DOI: 10.12659/MSM.933809
24 Sep 2021 : Database AnalysisRelationships Between Obstructive Sleep Apnea and Cardiovascular Disease: A Bibliometric Analysis (2010-2021)
Med Sci Monit In Press; DOI: 10.12659/MSM.933448
Most Viewed Current Articles
20 Mar 2020 : Clinical ResearchSocial Capital and Sleep Quality in Individuals Who Self-Isolated for 14 Days During the Coronavirus Diseas...
Med Sci Monit 2020; 26:e923921
15 Apr 2020 : Clinical ResearchPsychological Impact and Coping Strategies of Frontline Medical Staff in Hunan Between January and March 20...
Med Sci Monit 2020; 26:e924171
05 May 2020 : Review articleAn Evidence Based Perspective on mRNA-SARS-CoV-2 Vaccine Development
Med Sci Monit 2020; 26:e924700