Association between Charlson comorbidity index and complications of endoscopic resection of gastric neoplasms in elderly patients
Abstract Background Although endoscopic resection is safe and effective for gastric epithelial neoplasms, information is limited on its efficacy and safety in extremely elderly patients who have various comorbidities. Further, the relationship between comorbidities and complications of endoscopic re...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2020-07-01
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| Series: | BMC Gastroenterology |
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| Online Access: | http://link.springer.com/article/10.1186/s12876-020-01360-6 |
| _version_ | 1828498640428072960 |
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| author | Sunmin Kim Dong Hyun Kim Seon-Young Park Chang Hwan Park Hyun Soo Kim Sung Kyu Choi Jong Sun Rew |
| author_facet | Sunmin Kim Dong Hyun Kim Seon-Young Park Chang Hwan Park Hyun Soo Kim Sung Kyu Choi Jong Sun Rew |
| author_sort | Sunmin Kim |
| collection | DOAJ |
| description | Abstract Background Although endoscopic resection is safe and effective for gastric epithelial neoplasms, information is limited on its efficacy and safety in extremely elderly patients who have various comorbidities. Further, the relationship between comorbidities and complications of endoscopic resection is not well established. Therefore, we aimed to evaluate the efficacy and safety of endoscopic resection of gastric epithelial neoplasms in extremely elderly patients. Methods From October 2008 to December 2017, 4475 consecutive patients underwent endoscopic resection of gastric epithelial neoplasms. Among them, 242 were 75 years or older. We assessed Charlson comorbidity index (CCI) scores, procedural outcomes, and procedure- and sedation-related complications related to endoscopic resection. Results Mean patient age was 78.7 ± 3.2 years. Of the 242 patients, 124 (51.2%) had low-grade dysplasia and 112 (46.3%) had adenocarcinoma. The most common comorbidity was hypertension (55.4%), followed by diabetes (23.1%). The mean CCI score was 1.67 ± 1.43. Sixty patients (24.8%) had a CCI score ≥ 3. During the procedure, 10 (4.1%) patients had desaturation that recovered by flumazenil use with mask (n = 2) or Ambu bag (n = 3) ventilation. During subsequent admission, atelectasis or pneumonia occurred in 45 (18.6%) patients, post-procedural bleeding in 12 (5.0%), and perforation in 3 (1.2%). Respiratory complications were more common in patients with a CCI score ≥ 3 (20/60, 33.3%) than in those with a CCI score < 3 (25/182, 13.7%, P = 0.002). Conclusions CCI score is related to respiratory complications of endoscopic resection in extremely elderly patients. Endoscopic resection must be performed cautiously, particularly in elderly patients with a high CCI score, to prevent respiratory complications. |
| first_indexed | 2024-12-11T13:10:37Z |
| format | Article |
| id | doaj.art-6fbf559b9dbf42d0955e356c141be9cd |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-12-11T13:10:37Z |
| publishDate | 2020-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-6fbf559b9dbf42d0955e356c141be9cd2022-12-22T01:06:11ZengBMCBMC Gastroenterology1471-230X2020-07-012011810.1186/s12876-020-01360-6Association between Charlson comorbidity index and complications of endoscopic resection of gastric neoplasms in elderly patientsSunmin Kim0Dong Hyun Kim1Seon-Young Park2Chang Hwan Park3Hyun Soo Kim4Sung Kyu Choi5Jong Sun Rew6Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chonnam National Medical SchoolDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Chonnam National Medical SchoolDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Chonnam National Medical SchoolDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Chonnam National Medical SchoolDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Chonnam National Medical SchoolDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Chonnam National Medical SchoolDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Chonnam National Medical SchoolAbstract Background Although endoscopic resection is safe and effective for gastric epithelial neoplasms, information is limited on its efficacy and safety in extremely elderly patients who have various comorbidities. Further, the relationship between comorbidities and complications of endoscopic resection is not well established. Therefore, we aimed to evaluate the efficacy and safety of endoscopic resection of gastric epithelial neoplasms in extremely elderly patients. Methods From October 2008 to December 2017, 4475 consecutive patients underwent endoscopic resection of gastric epithelial neoplasms. Among them, 242 were 75 years or older. We assessed Charlson comorbidity index (CCI) scores, procedural outcomes, and procedure- and sedation-related complications related to endoscopic resection. Results Mean patient age was 78.7 ± 3.2 years. Of the 242 patients, 124 (51.2%) had low-grade dysplasia and 112 (46.3%) had adenocarcinoma. The most common comorbidity was hypertension (55.4%), followed by diabetes (23.1%). The mean CCI score was 1.67 ± 1.43. Sixty patients (24.8%) had a CCI score ≥ 3. During the procedure, 10 (4.1%) patients had desaturation that recovered by flumazenil use with mask (n = 2) or Ambu bag (n = 3) ventilation. During subsequent admission, atelectasis or pneumonia occurred in 45 (18.6%) patients, post-procedural bleeding in 12 (5.0%), and perforation in 3 (1.2%). Respiratory complications were more common in patients with a CCI score ≥ 3 (20/60, 33.3%) than in those with a CCI score < 3 (25/182, 13.7%, P = 0.002). Conclusions CCI score is related to respiratory complications of endoscopic resection in extremely elderly patients. Endoscopic resection must be performed cautiously, particularly in elderly patients with a high CCI score, to prevent respiratory complications.http://link.springer.com/article/10.1186/s12876-020-01360-6Endoscopic mucosal resectionAgedComorbidityStomach neoplasms |
| spellingShingle | Sunmin Kim Dong Hyun Kim Seon-Young Park Chang Hwan Park Hyun Soo Kim Sung Kyu Choi Jong Sun Rew Association between Charlson comorbidity index and complications of endoscopic resection of gastric neoplasms in elderly patients BMC Gastroenterology Endoscopic mucosal resection Aged Comorbidity Stomach neoplasms |
| title | Association between Charlson comorbidity index and complications of endoscopic resection of gastric neoplasms in elderly patients |
| title_full | Association between Charlson comorbidity index and complications of endoscopic resection of gastric neoplasms in elderly patients |
| title_fullStr | Association between Charlson comorbidity index and complications of endoscopic resection of gastric neoplasms in elderly patients |
| title_full_unstemmed | Association between Charlson comorbidity index and complications of endoscopic resection of gastric neoplasms in elderly patients |
| title_short | Association between Charlson comorbidity index and complications of endoscopic resection of gastric neoplasms in elderly patients |
| title_sort | association between charlson comorbidity index and complications of endoscopic resection of gastric neoplasms in elderly patients |
| topic | Endoscopic mucosal resection Aged Comorbidity Stomach neoplasms |
| url | http://link.springer.com/article/10.1186/s12876-020-01360-6 |
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