Safety of endoscopic retrograde cholangiopancreatography in patients 80 years of age and older

Baydar, Behlül; Serin, Ayfer; Vatansever, Sezgin; Kandemır, Altay; Çelik, Muhammet Reha; Çekiç, Cem; Bilge, Örmeci; Aslan, Fatih; Alper, Emrah; Buyraç, Zafer; Aksöz, Kadir; Ünsal, Belkıs

doi:10.5114/pg.2014.45105

Cited by 11 publications

(15 citation statements)

References 14 publications

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“…Prior small studies focusing on the very elderly such as octogenarians found a mortality rate of 0 – 1 % 3 6 7 8 9 10 16. The mortality of octogenarians in our study was over 3 %.…”

Section: Discussionsupporting

confidence: 39%

Endoscopic retrograde cholangiopancreatography in octogenarians: A population-based study using the nationwide inpatient sample

et al. 2016

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Background and study aims: In the elderly population, there is a growing demand for minimally invasive procedures as the incidence of pancreaticobiliary disease increases with age. Patients with advanced age offer unique challenges for any procedure because they also tend to have a higher rate of baseline comorbidities and malignancy. The aim of the current study was to characterize the mortality and length of stay of octogenarians undergoing inpatient endoscopic retrograde cholangiopancreatography (ERCP). Patients and methods: Using the 2007 – 2010 Nationwide Inpatient Sample (NIS), we performed a retrospective analysis of health-related outcomes among 80- to 89-year-old patients undergoing inpatient ERCP. Surgical patients were excluded. Results: An estimated 61,322 octogenarians underwent inpatient ERCP in the United States from 2007 to 2010. The mean age was 84.2 (SE 0.02) with 59.5 % (n = 36,460) of the patients being female. A large majority of the patients were white (79. %, n = 41,144) and 63.5 % (n = 38,940) had a comorbidity index of at least 2. The mean length of stay was 7.1 days (SE 0.08) with an in-hospital mortality of 3.1 % (n = 1,919). The primary discharge diagnosis was most often biliary stone disease (55.9 %, n = 34,263). A diagnosis of any infection was recorded in 45.0 % (n = 27,609) of patients. Infection was associated with a significantly higher risk of in-hospital mortality (OR 3.3, 95 % CI 2.6 – 4.2, P < 0.001). Conclusions: ERCP is now routinely being performed during inpatient admissions for octogenarians with diseases of the biliary tract. The mortality of octogenarians undergoing inpatient ERCP is higher than previous reports and is likely due to superimposed infection during the same admission.

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“…Prior small studies focusing on the very elderly such as octogenarians found a mortality rate of 0 – 1 % 3 6 7 8 9 10 16. The mortality of octogenarians in our study was over 3 %.…”

Section: Discussionsupporting

confidence: 39%

Endoscopic retrograde cholangiopancreatography in octogenarians: A population-based study using the nationwide inpatient sample

et al. 2016

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“…In previous reports, regarding the safety of ERCP for the older adults, most studies of therapeutic ERCP comparing older patients with younger patients have defined the age cut‐off for older patients as 70, 75 or 80 years. In most studies, investigators have reported that therapeutic ERCP was safe in older adults . However, there have been few reports on factors contributing to AE occurrence in ERCP for patients aged ≥85 years.…”

Section: Introductionmentioning

confidence: 99%

“…In most studies, investigators have reported that therapeutic ERCP was safe in older adults. [6][7][8][9] However, there have been few reports on factors contributing to AE occurrence in ERCP for patients aged ≥85 years. Further, although several studies have reported that ERCP was safe in patients aged ≥90 years, the control groups in several of them included younger patients.…”

Section: Introductionmentioning

confidence: 99%

Risk factors of adverse events in endoscopic retrograde cholangiopancreatography for patients aged ≥85 years

Takahashi

Tsuyuguchi

Sugiyama

et al. 2018

Geriatrics Gerontology Int

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“…It is important to estimate preprocedural risk factors accurately by means of objective clinical tools, applied to elderly patients with comorbidity and possible procedure-related adverse events, to produce satisfactory clinical ERCP outcomes (15). Previously, a number of studies have reported the safety and efficacy of ERCP for elderly patients (2)(3)(4)(5)(6). However, it is estimated that the risk factor for ERCP for elderly patients is not only age, but also other clinical conditions.…”

Section: Discussionmentioning

confidence: 99%

“…To date, ERCP has been known to be associated with severe adverse events, such as pancreatitis, gastrointestinal bleeding and perforation (1). Although it has been reported that ERCP can be safely performed in elderly patients (2)(3)(4)(5)(6), the clinical status of these patients varies due to comorbidities, nutritional status, cognition, etc., which causes endoscopists to debate whether or not ERCP should be performed. The Eastern Cooperative Oncology Group (ECOG) scale of performance status (PS) is widely used for the quantification of the general well-being and daily life activities of patients (7).…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of ERCP in elderly patients with an ECOG performance status of 3‑4

Asada¹,

Douhara²,

Ueno³

et al. 2020

World Acad Sci J

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The aim of the present study was to clarify the efficacy and safety of endoscopic retrograde cholangiopancreatography (ERCP) for elderly patients with a performance status (PS) of 3-4, which is the highest risk group. The records of patients aged over 75 years of age, who underwent ERCP at Saiseikai Chuwa Hospital from April, 2017 to April, 2018, were retrospectively analyzed. These patients were divided into the PS 0-2 group and PS 3-4 group. For both groups, clinical characteristics, such as age, sex, PS, the prevalence rate of moderate or severe cholangitis, Charlson comorbidity index (CCI), technical success rate, adverse events and fatal cases within 30 days following ERCP were analyzed. The results revealed that in total, 94 patients (158 procedures) aged over 75 years underwent ERCPs; 73 patients (116 procedures) were in the PS 0-2 group, and 21 patients (42 procedures) were in the PS 3-4 group. The average age did not differ significantly between the groups. The prevalence rates of moderate or severe cholangitis and CCI were higher in the PS 3-4 group. The technical success rate was high in both groups. Although the rate of adverse events did not differ between the 2 groups, 2 fatal cases occurred during the 30 days following ERCP in the PS 3-4 group. In each case, anorexia and an influenza infection led to a fatal outcome. Overall, this study demonstrates that ERCP for elderly patients with a PS of 3-4 is effective and safe. However, attention should be paid to ERCP in patients with a PS of 3-4, as it may result in a fatal outcome caused by incidents unrelated to the ERCP procedure.

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Safety of endoscopic retrograde cholangiopancreatography in patients 80 years of age and older

Cited by 11 publications

References 14 publications

Endoscopic retrograde cholangiopancreatography in octogenarians: A population-based study using the nationwide inpatient sample

Endoscopic retrograde cholangiopancreatography in octogenarians: A population-based study using the nationwide inpatient sample

Risk factors of adverse events in endoscopic retrograde cholangiopancreatography for patients aged ≥85 years

Efficacy and safety of ERCP in elderly patients with an ECOG performance status of 3‑4

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