Age comorbidity scores as risk factors for 90-day mortality in patients with a pancreatic head adenocarcinoma receiving a pancreaticoduodenectomy: A National Population-Based Study

Ben Chang Shia, Lei Qin, Kuan Chou Lin, Chih Yuan Fang, Lo Lin Tsai, Yi Wei Kao, Szu Yuan Wu

研究成果: 雜誌貢獻文章同行評審

19 引文 斯高帕斯(Scopus)

摘要

Background: To estimate easily assessed preoperative factors for predicting 90-day mortality in patients with a pancreatic head adenocarcinoma (PHA) receiving a pancreaticoduodenectomy. Methods: We analyzed data from the Taiwan Cancer Registry Database of patients with a PHA who received a pancreaticoduodenectomy. Basic demographic characteristics, including gender and age, were categorized. The selection of preoperative comorbidities was based on the preoperative American Society of Anesthesiologists score and Charlson comorbidity index. Results: We enrolled 8490 patients with a PHA who received a pancreaticoduodenectomy without distant metastasis. Currently, a pancreaticoduodenectomy for a PHA achieves an overall 90-day mortality rate of 8.39%. Univariate and multivariate Cox regression analyses indicated that an older age (65-74 and ≥75 years) and specific comorbidities (chronic obstructive pulmonary disease, chronic kidney disease, dementia, and sepsis) were significant independent prognostic factors for predicting 90-day mortality after a pancreaticoduodenectomy. After adjustment, the adjusted hazard ratios (aHRs) (95% confidence intervals [CIs]) of subjects with middle and high comorbidity scores for 90-day mortality in 65 to 74-year-old patients were 1.36 (1.05-1.75) and 2.25 (1.03-4.90), respectively, compared to subjects with low comorbidity scores. The aHRs (95% CIs) of subjects with middle and high comorbidity scores for 90-day mortality in ≥75-year-old patients were 1.35 (1.07-1.78) and 2.07 (1.19-3.62), respectively, compared to those with low comorbidity scores. Conclusions: Elderly patients with a PHA and moderate or high comorbidity scores have an increased risk of 90-day mortality after a pancreaticoduodenectomy.

原文英語
頁(從 - 到)562-574
頁數13
期刊Cancer Medicine
9
發行號2
DOIs
出版狀態已發佈 - 1月 1 2020

ASJC Scopus subject areas

  • 腫瘤科
  • 放射學、核子醫學和影像學
  • 癌症研究

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