Waike lilun yu shijian (Mar 2023)

Risk factors of severe postoperative complications in elderly patients with pancreaticoduodenectomy

  • YU Lan, ZHANG Yongyi, HUANG Lei, WAN Xin, JIANG Shengyao, TANG Sijing, ZHANG Jun, HU Weiguo

DOI
https://doi.org/10.16139/j.1007-9610.2023.02.10
Journal volume & issue
Vol. 28, no. 02
pp. 139 – 146

Abstract

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Objective To investigate the risk factors of severe complications of elderly patients with pancreaticoduodenectomy (PD). Methods The clinical data of 399 elderly patients with PD and 65 years or more (65-91years) including 76 cases with 75 years or more （19.0%） in this hospital from January 2016 to December 2020, were retrospectively analyzed. Less Barthel index score was used to indicate lower activities of daily living. The risk factors of severe complications after PD were analyzed by binary Logistic regression and predictive model was established. Receiver operating characteristic (ROC) curve was used to verify the predictive efficiency of model. Results A total of 224 cases were found postoperative complications from 399 elderly PD cases with the rate 56.14% including 187 (46.87%) cases of mild complications and 37 (9.27%) cases of severe complications. Age ≥75 years (OR=2.78, P<0.05), combined with hypertension (OR=4.20, P<0.05) and less Barthel index score (OR=0.96, P<0.05) were independent risk factors for severe complications after PD in elderly patients. The risk prediction model of severe postoperative complications of PD was constructed using 6 indexes including age, hypertension, preoperative nutritional risk, operative type, Barthel index score in activities of daily living and operative time, and the fit of regression equation 0.93. ROC curve analysis showed that area under curve (AUC) was 0.76, the sensiti-vity 65%, and the specificity 76%. Conclusions Age 75 years or more, hypertension and low activities of daily living would be independent risk factors for severe complications after PD in elderly patients. The risk model constructed by age, hypertension, preoperative nutritional risk, operative type, Barthel index score in activities of daily living and operative time had certain predictive efficacy for severe complications after PD in elderly patients.

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