The Clinical Impact of Advanced Age on the Postoperative Outcomes of Patients Undergoing Gastrectomy for Gastric Cancer: Analysis Across US Hospitals Between 2011-2017.

IF 3.2 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastric Cancer Pub Date : 2022-07-01 DOI:10.5230/jgc.2022.22.e18

David Uihwan Lee, Gregory Hongyuan Fan, Kevin Chang, Ki Jung Lee, John Han, Daniel Jung, Jean Kwon, Raffi Karagozian

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引用次数: 2

Abstract

Purpose: This study systematically evaluated the implications of advanced age on post-surgical outcomes following gastrectomy for gastric cancer using a national database.

Materials and methods: The 2011-2017 National Inpatient Sample was used to isolate patients who underwent gastrectomy for gastric cancer. From this, the population was stratified into those belonging to the younger age cohort (18-59 years), sexagenarians, septuagenarians, and octogenarians. The younger cohort and each advanced age category were compared in terms of the following endpoints: mortality following surgery, length of hospital stay, charges, and surgical complications.

Results: This study included a total of 5,213 patients: 1,366 sexagenarians, 1,490 septuagenarians, 743 octogenarians, and 1,614 under 60 years of age. Between the younger cohort and sexagenarians, there was no difference in mortality (2.27 vs. 1.67%; P=0.30; odds ratio [OR], 1.36; 95% confidence interval [CI], 0.81-2.30), length of stay (11.0 vs. 11.1 days; P=0.86), or charges ($123,557 vs. $124,425; P=0.79). Compared to the younger cohort, septuagenarians had higher rates of in-hospital mortality (4.30% vs. 1.67%; P<0.01; OR, 2.64; 95% CI, 1.67-4.16), length of stay (12.1 vs. 11.1 days; P<0.01), and charges ($139,200 vs. $124,425; P<0.01). In the multivariate analysis, septuagenarians had higher mortality (P=0.01; adjusted odds ratio [aOR], 2.01; 95% CI, 1.18-3.43). Similarly, compared to the younger cohort, octogenarians had a higher rate of mortality (7.67% vs. 1.67%; P<0.001; OR, 4.88; 95% CI, 3.06-7.79), length of stay (12.3 vs. 11.1 days; P<0.01), and charges ($131,330 vs. $124,425; P<0.01). In the multivariate analysis, octogenarians had higher mortality (P<0.001; aOR, 4.03; 95% CI, 2.28-7.11).

Conclusions: Advanced age (>70 years) is an independent risk factor for postoperative death in patients with gastric cancer undergoing gastrectomy.

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高龄对胃癌胃切除术患者术后结局的临床影响:2011-2017年美国医院分析

目的:本研究使用国家数据库系统评估高龄对胃癌胃切除术后预后的影响。材料与方法:选取2011-2017年全国住院患者样本，分离胃癌切除术患者。据此，将人群分为年轻年龄组(18-59岁)、60多岁、70多岁和80多岁。根据以下终点比较年轻队列和每个高龄类别:手术后死亡率、住院时间、费用和手术并发症。结果:本研究共纳入5213例患者，其中60岁老人1366例，70岁老人1490例，80岁老人743例，60岁以下1614例。在年轻组和60岁组之间，死亡率没有差异(2.27 vs 1.67%;P = 0.30;优势比[OR]， 1.36;95%可信区间[CI]， 0.81-2.30)、住院时间(11.0 vs. 11.1天;P=0.86)，或收费(123,557美元vs. 124,425美元;P = 0.79)。与年轻队列相比，70岁老人的住院死亡率更高(4.30% vs. 1.67%;结论:高龄(>70岁)是胃癌切除术患者术后死亡的独立危险因素。

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来源期刊

Journal of Gastric Cancer Biochemistry, Genetics and Molecular Biology-Cancer Research

CiteScore

4.30

自引率

12.00%

发文量

期刊介绍： The Journal of Gastric Cancer (J Gastric Cancer) is an international peer-reviewed journal. Each issue carries high quality clinical and translational researches on gastric neoplasms. Editorial Board of J Gastric Cancer publishes original articles on pathophysiology, molecular oncology, diagnosis, treatment, and prevention of gastric cancer as well as articles on dietary control and improving the quality of life for gastric cancer patients. J Gastric Cancer includes case reports, review articles, how I do it articles, editorials, and letters to the editor.