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接受治疗性内镜逆行胰胆管造影术的九旬老人的安全性:单中心经验

Safety of Nonagenarians Receiving Therapeutic ERCP, Single Center Experience.

作者信息

Chen Chia-Chang, Lin Wan-Tzu, Tung Chun-Fang, Lee Shou-Wu, Chang Chi-Sen, Peng Yen-Chun

机构信息

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan.

Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 40227, Taiwan.

出版信息

J Clin Med. 2022 Sep 2;11(17):5197. doi: 10.3390/jcm11175197.

Abstract

(1) Background: The complication rates for nonagenarians receiving therapeutic endoscopic retrograde cholangiopancreatography (ERCP) remain poorly understood. We aimed to determine whether nonagenarians were at an increased risk of ERCP-related complications. (2) Methods: We performed a retrospective study on therapeutic ERCP in nonagenarians from 2011 to 2016 at Taichung Veterans General Hospital. A control group comprising patients aged 65 to 89 years was used to compare demographic data and the outcomes of therapeutic ERCP with the nonagenarians. The risk factors for complications were determined by logistic regression model. (3) Results: There were 35 nonagenarians and 111 patients in the control group. Overall, complication rates were not statistically different between the two groups. However, advanced age was an independent predictor of complications in the multivariate analysis (odds ratio [OR] = 1.06; 95% confidence interval [CI] = 1.01-1.12; = 0.049). End stage renal disease (ESRD) was another independent predictor of complications (OR = 4.87; 95% CI = 1.11-21.36; = 0.036). Post-ERCP pancreatitis and bleeding were more common in ESRD patients than patients without ESRD. (4) Conclusions: Although nonagenarians receiving ERCP did not have more complications compared to elderly patients younger than 90 years, advanced age and comorbidity still affect the outcome of therapeutic ERCP in the elderly patients.

摘要

(1)背景:对于接受治疗性内镜逆行胰胆管造影术(ERCP)的九旬老人,其并发症发生率仍知之甚少。我们旨在确定九旬老人发生ERCP相关并发症的风险是否增加。(2)方法:我们对2011年至2016年在台中荣民总医院接受治疗性ERCP的九旬老人进行了一项回顾性研究。使用一个由65至89岁患者组成的对照组,以比较人口统计学数据以及治疗性ERCP与九旬老人的治疗结果。通过逻辑回归模型确定并发症的危险因素。(3)结果:对照组中有35名九旬老人和111名患者。总体而言,两组之间的并发症发生率在统计学上没有差异。然而,在多变量分析中,高龄是并发症的独立预测因素(比值比[OR]=1.06;95%置信区间[CI]=1.01-1.12;P=0.049)。终末期肾病(ESRD)是并发症的另一个独立预测因素(OR=4.87;95%CI=1.11-21.36;P=0.036)。与没有ESRD的患者相比,ESRD患者发生ERCP后胰腺炎和出血更为常见。(4)结论:尽管接受ERCP的九旬老人与90岁以下的老年患者相比并发症并不更多,但高龄和合并症仍然会影响老年患者治疗性ERCP的结果。

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