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Assessment of safety of non‐anesthesiologist‐assisted endoscopic retrograde cholangiopancreatography based on performance status in elderly patients
Author(s) -
Park Tae Young,
Choi Jung Sik,
Oh HyoungChul,
Kim Ju Wan,
Do Jae Hyuk,
Jung Yong Hun
Publication year - 2014
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12608
Subject(s) - medicine , endoscopic retrograde cholangiopancreatography , univariate analysis , pancreatitis , adverse effect , bradycardia , american society of anesthesiologists , multivariate analysis , group b , myocardial infarction , surgery , blood pressure , heart rate
Background and Aim Endoscopic retrograde cholangiopancreatography ( ERCP ) has been increasingly performed in the elderly patients, yet little is known concerning objective criteria of safety. This study aimed to determine the potential predictors for the procedure‐related outcomes. Methods Two hundred eighty‐one patients older than 70 years who were indicated for ERCP (group A [ n = 195], 70–79 years of age; group B [ n = 86], ≥ 80 years of age) were prospectively enrolled and analyzed for the development of serious adverse events related to ERCP . Results ERCP was not performed in six patients at high risk for the procedure. There were significant differences between group A and B in D uke Activity Status Index ( DASI ) (23.1 vs 14.9, P < 0.01) and Eastern Cooperative Oncology Group performance status (3 and 4, 49/195 vs 33/86, P < 0.05). Major ERCP ‐related complications (hypotension, severe bradycardia, hypoxia, myocardial infarction, cerebral infarction) occurred in five patients from group B and three from group A . Post‐ ERCP pancreatitis occurred in one patient from group A and bleeding in one from group B . In univariate analysis, old age (≥ 80 years), American Society of Anesthesiologists score ≥ 3, and DASI < 10 were statistically significant predictors for overall serious events related to ERCP . In the multivariate analysis, DASI < 10 (only manage to ambulate) was independent predictor for overall serious events related to ERCP . Conclusion DASI score is useful predictor for the feasibility assessment of safe ERCP in the elderly patients.