Risk factors of severe postoperative complications in elderly patients with pancreaticoduodenectomy
Journal Title: Journal of Surgery : Concepts & Practice - Year 2023, Vol 28, Issue 2
Abstract
[Objective] To investigate the risk factors of severe complications of elderly patients with pancreaticoduodenectomy (PD). [Methods] The clinical data of 399 elderly patients with PD and 65 years or more (65-91years) including 76 cases with 75 years or more （19.0%） in this hospital from January 2016 to December 2020, were retrospectively analyzed. Less Barthel index score was used to indicate lower activities of daily living. The risk factors of severe complications after PD were analyzed by binary Logistic regression and predictive model was established. Receiver operating characteristic (ROC) curve was used to verify the predictive efficiency of model. [Results] A total of 224 cases were found postoperative complications from 399 elderly PD cases with the rate 56.14% including 187 (46.87%) cases of mild complications and 37 (9.27%) cases of severe complications. Age ≥75 years (OR=2.78, P<0.05), combined with hypertension (OR=4.20, P<0.05) and less Barthel index score (OR=0.96, P<0.05) were independent risk factors for severe complications after PD in elderly patients. The risk prediction model of severe postoperative complications of PD was constructed using 6 indexes including age, hypertension, preoperative nutritional risk, operative type, Barthel index score in activities of daily living and operative time, and the fit of regression equation 0.93. ROC curve analysis showed that area under curve (AUC) was 0.76, the sensiti-vity 65%, and the specificity 76%. [Conclusions] Age 75 years or more, hypertension and low activities of daily living would be independent risk factors for severe complications after PD in elderly patients. The risk model constructed by age, hypertension, preoperative nutritional risk, operative type, Barthel index score in activities of daily living and operative time had certain predictive efficacy for severe complications after PD in elderly patients.
Authors and Affiliations
Lan YU, Yongyi ZHANG, Lei HUANG, Xin WAN, Shengyao JIANG, Sijing TANG, Jun ZHANG, Weiguo HU
Keywords
Related Articles
- EP ID EP750858
- DOI 10.16139/j.1007-9610.2023.02.10
- Views 16
- Downloads 0
Effect of mismatch repair genes expression in right colon cancer on pathological characteristics
[Objective] To investigate the defect of expression of mismatch repair genes(MMR) including MLH1, MSH2, MSH6 and PMS2 in sporadic colon cancer, and analyze the expression of MMR related to pathological change of patients...
Emerging developments in immune checkpoint inhibitor therapy for gastroenteropancreatic neuroendocrine neoplasm
Immunotherapies targeting immune checkpoints have undergone rapid evolution, and have been preliminary explored in treatment of gastroenteropancreatic neuroendocrine neoplasm (GEP-NEN) in recent years. However, their pot...
Update of pathology in medullary thyroid carcinoma
Medullary thyroid carcinoma (MTC) is a rare thyroid malignancy, which is more aggressive with high metastasis and recurrence rate. Surgical treatment is the preferred treatment option for MTC. Targeted therapy and immuno...
Research and guidelines interpretation of neoadjuvant therapy for resectable pancreatic cancer, promising or limited?
As a systemic disease, pancreatic cancer is highly malignant and has a high rate of recurrence and metastasis, which makes it particularly difficult in diagnosis, treatment and management. In recent years, with the conce...
Efficacy of intraoperative indocyanine green fluorescence imaging evaluation for preventing anastomotic leakage after laparoscopic rectal cancer surgery
[Objective] To investigate the effect of indocyanine green(ICG) fluorescence imaging to indicate blood supply of sigmoid-rectal anastomosis in laparoscopic anterior resection of rectal cancer. [Methods] Here a retrospect...