年龄超过 80 岁对老年急性胰腺炎患者预后的影响:单中心经验

Hakan Şivgin, Abdurrahman Şahi̇n
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引用次数: 0

摘要

本研究旨在评估老年急性胰腺炎(AP)的预后和死亡率,并将八旬老人(≥80 岁)与非八旬老人(0.05 岁)进行比较。13%的八旬老人和11%的非八旬老人住进了重症监护室(P>0.05)。8.3% 的八旬老人和 6.8% 的非八旬老人出现院内死亡(P>0.05)。出院后,20% 的八旬老人和 6.6% 的非八旬老人在一年内死亡(P<0.01)。在多变量分析中,严重 AP(OR:24.940;%95CI:1.013-95.609; p=0.01)、入住 ICU(OR:10.244;%95CI:1.399-74.990; p=0.01)和慢性肾脏病(CKD)(OR:9.840;%95CI:1.013-95.609; p=0.≥80岁(OR:2.984;%95CI:1.116-7.980; p =0.03)和神经系统疾病(OR:4.424;%95CI:1.480-13.226; p <0.01)是与一年死亡率相关的独立危险因素。我们的研究结果表明,年龄对老年人 AP 的病程影响不大。合并症对老年人的短期和长期预后都有重要影响。要得出更明确的结论,还需要进行更大规模的前瞻性试验。
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The Impact of Age Over 80 Years on Outcomes in Geriatric Patients with Acute Pancreatitis: A Single Center Experience
The aim of this study is to evaluate the prognosis and mortality of acute pancreatitis (AP) in older subjects and compare octogenarians (≥80 years) with nonoctogenarians (age <80 years). The medical records of elderly patients who were followed up with the diagnosis of AP at our clinic between January 2018 and December 2021 were retrospectively analyzed. The etiology of AP, comorbidities, laboratory parameters, intensive care unit (ICU) admission, and mortality were noted. Among survivors, one-year mortality status was also recorded. Disease severity, in-hospital mortality and one-year mortality were compared. A total of 206 older patients (60 octogenarian, 146 nonoctogenariean) were recruited to the study. Of them, 115 (56%) were female and the mean age was 76.1±7.3 years. Severity of AP didn’t differ between octogenarians and nonctogenarians (p>0.05). ICU admission was seen in 13% of octogenarians and 11% of nonoctogenarians (p>0.05). In-hospital mortality occurred in 8.3% of octogenarians and 6.8% of nonoctogenarians (p>0.05). After discharge, one-year mortality occurred in 20% of octogenarians and 6.6% of nonoctogenarians (p<0.01). In multivariate analysis severe AP (OR:24.940;%95CI:1.013–95.609; p=0.01), ICU admission (OR:10.244;%95CI:1.399–74.990; p=0.01) and chronic kidney disease(CKD) (OR:9.840;%95CI:1.013–95.609; p=0.04) were independent risk factors for in-hospital mortality, and ≥80 years (OR:2.984;%95 CI:1.116–7.980; p =0.03) and neurological disorders (OR:4.424;%95CI:1.480–13.226; p <0.01) were independent factors related to one-year mortality. Our results showed that advenced age has not a significant effect on the course of AP in elderly. Comorbidities play important role in short- and long-term outcomes in elderly. Larger prospective trials are needed to draw more definitive conclusions.
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