Assessment of safety of non‐anesthesiologist‐assisted endoscopic retrograde cholangiopancreatography based on performance status in elderly patients. Issue 11 (November 2014)

• Record Type: Journal Article
• Authors: Park, Tae Young; Choi, Jung Sik; Oh, Hyoung‐Chul; Kim, Ju Wan; Do, Jae Hyuk; Jung, Yong Hun
• Is Part Of: Journal of gastroenterology and hepatology. Volume 29:Issue 11(2014:Nov.)
• Page Start: 1943
• Page End: 1948
• Publication Date: 2014-11
• Subjects: Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; Liver -- Diseases -- Periodicals; Gastroenterology -- Periodicals; Liver Diseases -- Periodicals; 616.33
• DOI: 10.1111/jgh.12608
• Languages: English
• ISSNs: 0815-9319

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="jgh12608-sec-0001" sec-type="section"> <title>Background and Aim</title> <p>Endoscopic retrograde cholangiopancreatography (ERCP) has been increasingly performed in the elderly patients, yet little is known concerning objective criteria of safety. This study aimed to determine the potential predictors for the procedure‐related outcomes.</p> </sec> <sec id="jgh12608-sec-0002" sec-type="section"> <title>Methods</title> <p>Two hundred eighty‐one patients older than 70 years who were indicated for ERCP (group A [<italic>n</italic> = 195], 70–79 years of age; group B [<italic>n</italic> = 86], ≥ 80 years of age) were prospectively enrolled and analyzed for the development of serious adverse events related to ERCP.</p> </sec> <sec id="jgh12608-sec-0003" sec-type="section"> <title>Results</title> <p>ERCP was not performed in six patients at high risk for the procedure. There were significant differences between group A and B in Duke Activity Status Index (DASI) (23.1 <italic>vs</italic> 14.9, <italic>P</italic> < 0.01) and Eastern Cooperative Oncology Group performance status (3 and 4, 49/195 <italic>vs</italic> 33/86, <italic>P</italic> < 0.05). Major ERCP‐related complications (hypotension, severe bradycardia, hypoxia, myocardial infarction, cerebral infarction) occurred in five patients from group B and three from group A. Post‐ERCP pancreatitis occurred in one patient from group A and bleeding in one from group B. In univariate analysis, old age (≥ 80 years), American Society of Anesthesiologists score ≥ 3, and DASI < 10 were statistically significant predictors for overall serious events related to ERCP. In the multivariate analysis, DASI < 10 (only manage to ambulate) was independent predictor for overall serious events related to ERCP.</p> </sec> <sec id="jgh12608-sec-0004" sec-type="section"> <title>Conclusion</title> <p>DASI score is useful predictor for the feasibility assessment of safe ERCP in the elderly patients.</p> </sec> </abstract>