Potential impact of aortic stenosis diagnosis on mortality and other in-hospital complications in patients with pancreatic cancer undergoing pancreaticoduodenectomy.

Background: Patients with aortic stenosis undergoing noncardiac surgery pose a dilemma to physicians as they are at an increased risk for complications. This study aims to investigate the effect of aortic stenosis on mortality and other complications in patients with pancreatic cancer undergoing pancreaticoduodenectomy.

Methods: We investigated patients with pancreatic cancer undergoing pancreaticoduodenectomy between 2016 and 2019 using the National Inpatient Sample database. The study population was divided based on the presence or absence of aortic stenosis. Multivariate logistic regression analyses were performed to determine factors associated with in-hospital mortality and other complications.

Results: Of the 16,150 patients with pancreatic cancer who underwent pancreaticoduodenectomy, 165 patients were diagnosed with aortic stenosis. The mean age of patients with aortic stenosis was significantly higher. Patients with aortic stenosis had a significantly higher in-hospital mortality, occurrence of cardiac arrest, and ICU admission compared with patients without aortic stenosis. There was no difference in mechanical ventilation, hospital charges, and length of stay between the two groups.

Conclusions: Aortic stenosis was found to be associated with higher in-hospital mortality and worse outcomes in patients with pancreatic cancer undergoing pancreaticoduodenectomy. Preoperative risk stratification and a multidisciplinary approach to perioperative management, among other measures, should be considered to improve outcomes.