Frailty is a useful predictive marker of postoperative complications after pancreaticoduodenectomy

Yutaka Nakano, Yuki Hirata, Tatsuya Shimogawara, Toru Yamada, Koki Mihara, Ryo Nishiyama, Shin Nishiya, Hideki Taniguchi, Tomohisa Egawa

Research output: Contribution to journalArticle

Abstract

Background: Frailty results in a high risk for disability, hospitalization, and mortality. This study aimed to investigate perioperative details of frail patients who underwent pancreatectomy and whether frailty can be a predictive factor of postoperative complications, especially of clinically relevant postoperative pancreatic fistula (CR-POPF). Methods: This retrospective study included patients who underwent pancreatectomy in our hospital between August 2016 and March 2019. The patients were divided into frail and pre-/non-frail groups. The diagnostic criteria were based on the Japanese version of the Cardiovascular Health Study. Results: Of 93 patients, 11 (11.8%) and 82 (88.2%) were frail and pre-/non-frail patients, with median ages of 82 and 72 years, respectively (p = 0.041). Postoperative complications (Clavien-Dindo ≧ IIIa) were found in 8 and 32 patients (p = 0.034), CR-POPF in 3 and 13 patients (p = 0.346), and postoperative hospital stays were 21 and 17 days (p = 0.041), respectively. On multivariate analysis, frailty was an independent predictive factor (odds ratio [OR] 5.604, 95.0% confidence interval [CI] 1.002-30.734; p = 0.047) of postoperative complications (Clavien-Dindo ≧ IIIa) after pancreaticoduodenectomy. On multivariate analysis, a soft pancreas (OR 5.696, 95.0% CI 1.142-28.149; p = 0.034) was an independent and significant predictive factor of CR-POPF after pancreaticoduodenectomy. Conclusions: Frailty may be a useful predictive factor of postoperative complications in patients undergoing pancreaticoduodenectomy.

Original languageEnglish
Article number194
JournalWorld Journal of Surgical Oncology
Volume18
Issue number1
DOIs
Publication statusPublished - 2020 Aug 3

Keywords

  • Clinically relevant postoperative pancreatic fistula
  • Frailty
  • Pancreaticoduodenectomy
  • Postoperative complications
  • Sarcopenia

ASJC Scopus subject areas

  • Surgery
  • Oncology

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    Nakano, Y., Hirata, Y., Shimogawara, T., Yamada, T., Mihara, K., Nishiyama, R., Nishiya, S., Taniguchi, H., & Egawa, T. (2020). Frailty is a useful predictive marker of postoperative complications after pancreaticoduodenectomy. World Journal of Surgical Oncology, 18(1), [194]. https://doi.org/10.1186/s12957-020-01969-7