title: Pancreaticoduodenectomy hospital resource utilization in octogenarians.
abstract: BACKGROUND
  Although pancreaticoduodenectomy (PD) is feasible in patients greater than or equal to 80 years, little is known about the potential strain on resource utilization.
  
  
  METHODS
  Outcomes and inpatient charges were compared across age cohorts (I: ≤70, II: 71 to 79, III: ≥80 years) in 99 patients who underwent PD (2005 to 2013) at our institution. The generalized linear modeling approach was used to estimate the impact of age.
  
  
  RESULTS
  Perioperative complications were equivalent among cohorts. Increasing age was associated with intensive care unit use, increased length of stay (LOS), and the likelihood of discharge to a skilled facility. After controlling for covariates, hospital charges were significantly higher in Cohort III (P = .006) and Cohort II (P = .035) when compared with Cohort I. However, hospital charges between Cohorts II and III were equivalent (P = .374). Complications (P = .005) and LOS (P < .001) were associated with higher hospital charges.
  
  
  CONCLUSIONS
  Increasing age was associated with increased intensive care unit, LOS, and discharge to skilled facilities. However, octogenarians had equivalent PD charges and outcome measures when compared with septuagenarians and future studies should validate these findings in larger national studies.
authors.affiliation: Department of Surgery, Georgetown University Hospital, 3800 Reservoir Road, Washington, DC 20007, USA.
authors.forename: Russell C
authors.initials: RC
authors.lastname: Langan
authors.affiliation: MedStar Health Research Institute, Washington, DC, USA.
authors.forename: Chun-Chih
authors.initials: CC
authors.lastname: Huang
authors.affiliation: Department of Surgery, Georgetown University Hospital, 3800 Reservoir Road, Washington, DC 20007, USA.
authors.forename: Weisheng Renee
authors.initials: WR
authors.lastname: Mao
authors.affiliation: Department of Surgery, Georgetown University Hospital, 3800 Reservoir Road, Washington, DC 20007, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Harris
authors.affiliation: Department of Surgery, Georgetown University Hospital, 3800 Reservoir Road, Washington, DC 20007, USA.
authors.forename: Will
authors.initials: W
authors.lastname: Chapman
authors.affiliation: Department of Surgery, Georgetown University Hospital, 3800 Reservoir Road, Washington, DC 20007, USA.
authors.forename: Charles
authors.initials: C
authors.lastname: Fehring
authors.affiliation: Department of Surgery, Georgetown University Hospital, 3800 Reservoir Road, Washington, DC 20007, USA.
authors.forename: Kesha
authors.initials: K
authors.lastname: Oza
authors.affiliation: Department of Surgery, Georgetown University Hospital, 3800 Reservoir Road, Washington, DC 20007, USA.
authors.forename: Patrick G
authors.initials: PG
authors.lastname: Jackson
authors.affiliation: Department of Radiology, Georgetown University Hospital, Washington, DC, USA.
authors.forename: Reena
authors.initials: R
authors.lastname: Jha
authors.affiliation: Department of Gastroenterology, Georgetown University Hospital, Washington, DC, USA.
authors.forename: Nadim
authors.initials: N
authors.lastname: Haddad
authors.affiliation: Department of Gastroenterology, Georgetown University Hospital, Washington, DC, USA.
authors.forename: John
authors.initials: J
authors.lastname: Carroll
authors.affiliation: Department of Surgery, Georgetown University Hospital, 3800 Reservoir Road, Washington, DC 20007, USA.
authors.forename: Jane
authors.initials: J
authors.lastname: Hanna
authors.affiliation: Department of Surgery, Georgetown University Hospital, 3800 Reservoir Road, Washington, DC 20007, USA.
authors.forename: Ann
authors.initials: A
authors.lastname: Parker
authors.affiliation: Department of Surgery, Georgetown University Hospital, 3800 Reservoir Road, Washington, DC 20007, USA.
authors.forename: Waddah B
authors.initials: WB
authors.lastname: Al-Refaie
authors.affiliation: Department of Surgery, Georgetown University Hospital, 3800 Reservoir Road, Washington, DC 20007, USA. Electronic address: JOHNSOL3@gunet.georgetown.edu.
authors.forename: Lynt B
authors.initials: LB
authors.lastname: Johnson
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000191:economics / Q000601:surgery*; D004219:District of Columbia; D005260:Female; D017722:Hospital Charges / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units / Q000191:economics / Q000706:statistics & numerical data; D007902:Length of Stay / Q000191:economics; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010190:Pancreatic Neoplasms / Q000191:economics / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000191:economics*; D011183:Postoperative Complications / Q000191:economics; D012189:Retrospective Studies
keywords: Age disparity; Octogenarian; Surgical cost analysis; Whipple