title: Pre- and intraoperative variables affecting early outcomes in elderly patients undergoing pancreaticoduodenectomy.
abstract: BACKGROUND
  Conflicting data exist regarding the safety of pancreatic resections in elderly patients. In this study we compared early complication and mortality rates between patients younger and older than 80 years of age who underwent pancreaticoduodenectomy using a validated national database.
  
  
  METHODS
  The National Surgical Quality Improvement Program (NSQIP) database for 2005-2009 was used for this retrospective analysis. The primary outcome measures for our analysis were 30-day postoperative mortality, major complication rate and overall complication rate.
  
  
  RESULTS
  A total of 6293 patients who underwent PD for any cause were included in the analysis. Of these, 9.4% were aged ≥80 years. The incidence of 30-day mortality was significantly higher in patients aged ≥80 years (6.3%) than in those aged <80 years (2.7%). Older patients were also noted to have higher rates of overall complications and serious complications. On multivariate analysis, age, ASA (American Society of Anesthesiologists) classification, reduced functional status, history of dyspnoea, and need for intraoperative transfusion were risk factors associated with the occurrence of overall complications, serious complications and postoperative mortality.
  
  
  CONCLUSIONS
  This study shows that age among other factors is a determinant of postoperative morbidity and mortality following PD.
authors.affiliation: Department of Surgical Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA. Sebastian.delafuente@moffitt.org
authors.forename: Sebastian G
authors.initials: SG
authors.lastname: de la Fuente
authors.forename: Kyla M
authors.initials: KM
authors.lastname: Bennett
authors.forename: Theodore N
authors.initials: TN
authors.lastname: Pappas
authors.forename: John E
authors.initials: JE
authors.lastname: Scarborough
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D019992:Databases as Topic; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D016577:Pancreaticoduodenectomy / Q000009:adverse effects* / Q000401:mortality; D018579:Patient Selection; D011183:Postoperative Complications / Q000209:etiology* / Q000401:mortality; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States
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