Usefulness of simplified comprehensive geriatric assessment as a pre-ERCP screening for the elderly.

IF 3.2 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2024-12-06 DOI:10.1002/jhbp.12093

Shuzo Nomura, Kei Saito, Mariko Fujisawa, Mai Kitahara, Noriyuki Kuniyoshi, Hiroo Imazu, Hirofumi Kogure

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引用次数: 0

Abstract

Background: Endoscopic retrograde cholangiopancreatography (ERCP) is often performed in elderly patients for stone removal and biliary drainage following common bile duct stones or malignant biliary obstruction. Safety in ERCP should be considered in elderly patients due to complications and decreased activities of daily living (ADL), but there are no adequate pretest evaluation criteria. In recent years, the usefulness of the comprehensive geriatric assessment (CGA) for planning treatment and predicting prognosis has been reported.

Methods: We retrospectively analyzed consecutive patients who underwent ERCP at our institution between October 2021 and June 2023. The relationship between CGA and ERCP outcomes was examined by dividing CGA scores into three groups (Group A; score 0, Group B; score 1-4, Group C; score 5-7) among patients 65 years of age and older. Risk factors for prolonged hospitalization were identified using univariate and multivariate analysis.

Results: Of the 388 patients, 290 were 65 or older with a CGA score. The median length of hospital stay was significantly longer in the higher CGA7 scores group (5 vs. 8 vs. 15 days, p < .01). There was no significant difference in the rate of adverse events (p = .54) and median total procedure time (p = .35). In univariate and multivariate analysis, higher CGA score groups were significant risk factors for a prolonged hospital stay.

Conclusions: CGA appears to be a valuable tool for preadmission screening in elderly patients undergoing ERCP.

查看原文本刊更多论文

简化综合老年病评估作为老年人ercp前筛查的有效性。

背景：内镜下逆行胆管造影（ERCP）常用于老年患者胆总管结石或恶性胆道梗阻后的结石取出和胆道引流。由于并发症和日常生活活动（ADL）下降，老年患者应考虑ERCP的安全性，但没有足够的试验前评估标准。近年来，综合老年评估（comprehensive geriatric assessment， CGA）在治疗计划和预测预后方面的应用有所报道。方法：我们回顾性分析了2021年10月至2023年6月期间在我院接受ERCP的连续患者。通过将CGA评分分为三组(A组；0分，B组；1-4分，C组；65岁及以上患者评分5-7分。通过单因素和多因素分析确定延长住院时间的危险因素。结果：在388例患者中，290例年龄在65岁及以上且有CGA评分。CGA7评分较高组的中位住院时间明显更长（5天vs. 8天vs. 15天）。结论：CGA似乎是接受ERCP的老年患者入院前筛查的有价值的工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY

自引率

10.00%

发文量

178

审稿时长

6-12 weeks

期刊介绍： The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.