Safety of esophageal EMR in elderly patients.
BACKGROUND
EMR is commonly used to remove suspicious esophageal lesions among patients with Barrett's esophagus (BE). BE primarily affects older patients. Yet, the safety profile of EMR in elderly patients has not been well-described.


OBJECTIVE
We aimed to study the safety profile of EMR in elderly patients compared with younger patients.


METHODS
Retrospective, observational, descriptive study that used a prospective database.


METHODS
Tertiary-care referral center.


METHODS
A total of 136 patients who underwent esophageal EMR for BE.


METHODS
EMR with/without ablative therapy.


METHODS
The rate of adverse events, including bleeding, stricture formation, and perforation between elderly (aged ≥75 years) and younger (aged <75 years) patients.


RESULTS
We identified 136 patients who underwent esophageal EMR who were followed-up in our clinic. Of those, 40% (n = 55) were aged ≥75 years (elderly group) and 60% (n = 81) were aged <75 years (younger group). There was no difference in rate of stricture formation or early or delayed bleeding when we compared elderly patients to younger patients. None of the patients had esophageal perforation. On multivariable logistic regression analysis, controlling for patient sex, EMR technique, and underlying pathology, older age was not associated with increased odds of adverse events (OR 0.88; 95% confidence interval, 0.42-1.9; P = .75).


CONCLUSIONS
Single-center experience.


CONCLUSIONS
Rates of adverse events from EMR appear to be similar in elderly patients compared with younger patients. Overall, esophageal EMR seems to offer an acceptable safety profile in elderly patients.
Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida.
Bashar
B
Qumseya
Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida.
Waseem
W
David
Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida.
Timothy A
TA
Woodward
Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida.
Massimo
M
Raimondo
Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida.
Michael B
MB
Wallace
Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida.
Herbert C
HC
Wolfsen
Department of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida.
Frank J
FJ
Lukens
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001471:Barrett Esophagus / Q000473:pathology* / Q000601:surgery*; D015331:Cohort Studies; D004945:Esophagoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009092:Mucous Membrane / Q000601:surgery; D015999:Multivariate Analysis; D061214:Patient Safety; D012189:Retrospective Studies; D018570:Risk Assessment; D062606:Tertiary Care Centers; D016896:Treatment Outcome