Akut Pankreatitli Geriatrik Hastalarda 80 Yaş Üstü Olmanın Sonuçlar Üzerindeki Etkisi: Tek Merkez Deneyimi

Öz

Bu çalışmanın amacı yaşlı bireylerde akut pankreatitin (AP) prognozunu ve mortalitesini değerlendirmek ve 80 yaş ve üzeri hastaları, 80 yaş altı hastalarla karşılaştırmaktır. Ocak 2018-Aralık 2021 tarihleri arasında kliniğimizde AP tanısı ile takip edilen yaşlı hastaların tıbbi kayıtları retrospektif olarak incelendi. Akut pankreatit nedeni, komorbiditeler, laboratuvar parametreleri, yoğun bakım ünitesine (YBÜ) yatış ve mortalite kaydedildi. Taburcu edilenlerde bir yıllık sağkalım durumu da kaydedildi. Akut pankreatit şiddeti, hastane mortalitesi ve bir yıllık mortalite karşılaştırıldı. Çalışmaya toplam 206 yaşlı hasta (60’ı 80 yaş üzeri, 146’sı 80 yaş altı) dahil edildi. Bunların 115'i (%56) kadındı ve yaş ortalaması 76.1±7.3 yıldı. AP şiddeti 80 yaş üzeri ve altı hastalar arasında farklılık göstermedi (p>0.05). YBÜ’nde yatış 80 yaş üzeri hastaların %13’ünde, 80 yaş altı hastaların %11’inde mevcuttu (p>0.05). Seksen yaş üzeri hastaların %8.3’ ünde, 80 yaş altı hastaların %6.8’inde hastane mortalitesi meydana geldi (p>0.05). Yaşayan hastalarda, taburculuk sonrası bir yıllık mortalite 80 yaş üzeri olanların %20’sinde ve 80 yaş altı olanların %6.6’ sında görüldü (p<0.01). Çok değişkenli analizde şiddetli AP (OR:24.940; %95CI:1.013–95.609; p=0.01), YBÜ yatışı (OR:10.244; %95CI:1.399–74.990; p=0.01) ve kronik böbrek hastalığı (KBH) (OR:9.840; %95CI:1.013–95.609; p=0.04) hastane mortalitesi için bağımsız risk faktörleriyken, 80 yaş üzeri olmak (OR: 2.984;%95 CI:1.116–7.980; p =0.03) ve nörolojik hastalıklar (OR:4.424;%95CI:1.480–13.226; p <0.01) bir yıllık mortaliteyle ilişkili bağımsız faktörlerdi. Sonuçlarımız ileri yaşın yaşlılarda AP seyri üzerinde belirgin bir etkisinin olmadığını gösterdi. Yaşlılarda, komorbiditeler kısa ve uzun dönem sonuçlarda önemli rol oynamaktadır. Daha kesin sonuçlara varmak için daha büyük prospektif çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• Akut pankreatit
• Yaşlılar
• Mortalite
• Seksen Yaş Üzeri
• Hastalık Şiddeti

The Impact of Age Over 80 Years on Outcomes in Geriatric Patients with Acute Pancreatitis: A Single Center Experience

Öz

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.

Anahtar Kelimeler

• Acute pancreatitis
• Elderly
• Mortality
• Octagenarians
• Severity

Kaynakça

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