Chijiiwa K, Yamaguchi K, Yamashita H, Ogawa Y, Yoshida J, Tanaka M
Department of Surgery 1, Kyushu University Faculty of Medicine, Fukuoka, Japan.
Am Surg. 1996 Sep;62(9):701-5.
To evaluate the effects of age and physical status on postoperative complications, American Society of Anesthesiologists-Physical Status score (ASA score) and age were analyzed in patients undergoing pancreatoduodenectomy (PD). Medical records and follow-up results of 69 patients who had undergone PD from 1980 to 1993 at one institution were examined. Clinical variables affecting morbidity and mortality rates were analyzed, and compared between two-aged groups (> or = 70 years (n = 18) and < 70 (n = 51)). Univariate Cox regression analysis of 69 patients showed that ASA score and age were not significant factors affecting postoperative morbidity, mortality, and survival. The clinical variables including ASA score, gender, operative time, blood loss, stage, and location of carcinoma were similarly distributed between the two-aged groups. The mortality rate in patients less than 70 years of age was 5.9 per cent (3/51), whereas there was no mortality in patients more than 70 years of age. The morbidity, mortality, and cumulative survival rates were statistically similar in the two age groups. The results suggest that ASA-physical status and age are not limiting factors for PD and do not predict survival. The procedure is safe and worthwhile even in patients more than 70 years of age with the ASA score up to III.
为评估年龄和身体状况对术后并发症的影响，我们对接受胰十二指肠切除术（PD）的患者的美国麻醉医师协会身体状况评分（ASA评分）和年龄进行了分析。我们检查了1980年至1993年在一家机构接受PD手术的69例患者的病历和随访结果。分析了影响发病率和死亡率的临床变量，并在两个年龄组（≥70岁（n = 18）和＜70岁（n = 51））之间进行了比较。对69例患者的单因素Cox回归分析表明，ASA评分和年龄不是影响术后发病率、死亡率和生存率的显著因素。包括ASA评分、性别、手术时间、失血量、分期和癌灶位置在内的临床变量在两个年龄组中的分布相似。年龄小于70岁的患者死亡率为5.9%（3/51），而年龄大于70岁的患者无死亡病例。两个年龄组的发病率、死亡率和累积生存率在统计学上相似。结果表明，ASA身体状况和年龄不是PD的限制因素，也不能预测生存率。即使对于ASA评分高达III级的70岁以上患者，该手术也是安全且值得的。
