The Charlson age comorbidity index predicts early mortality after surgery for pancreatic cancer

The Charlson age comorbidity index predicts early mortality after surgery for pancreatic cancer
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DOI：
10.1016/j.surg.2014.12.006
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发表时间：
2015-05-01
期刊：
SURGERY
影响因子：
3.8
通讯作者：
Fernandez-del Castillo, Carlos
Fernandez-del Castillo, Carlos
中科院分区：
医学2区
文献类型：
--
作者：
Dias-Santos, Daniela;Ferrone, Cristina R.;Fernandez-del Castillo, Carlos

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背景。虽然手术切除是治愈胰腺癌的唯一希望，但它与显著的发病率和死亡率相关。此外，在一些患者的疾病发生在术后很早就，从手术中看不到明显的好处。术前确定手术后一年内死亡的预测因素有助于胰腺癌患者的咨询。我们回顾性研究了2002年至2012年接受胰腺腺癌切除术的患者。我们计算了年龄调整的Charlson年龄合并症指数（CACI）和逻辑回归模型，以确定手术1年内死亡率的预测因子。建立Kaplan-Meier曲线和Cox比例风险模型来确定生存率的风险比。497例患者行手术治疗；136例（27%）在一年内死亡。CACI评分bbbb4可预测住院时间延长（P < 0.001）、术后并发症（P = 0.042）和胰腺切除术后1年内的死亡率（P < 0.001）。CACI评分为bb0 = 6时，第一年死亡几率增加3倍。CACI可用于预测胰腺癌切除术后的预后。CACI评分高的患者
Background. Although operative resection represents the only hope for cure in pancreatic cancer, it is associated with significant morbidity and mortality. Furthermore, in some patients disease occurs very early postoperatively and no tangible benefit is seen from the operation. Identification of preoperative predictors of death within the first year of surgery could help in the counseling of diagnosed with pancreatic cancer.Methods. We studied retrospectively patients who underwent resection for pancreatic adenocarcinoma from 2002 to 2012. We calculated the age-adjusted Charlson Age Comorbidity Index (CACI) and logistic regression models to determine predictors of mortality within 1 year of surgery. Kaplan-Meier curves and Cox proportional hazards models were developed to determine hazard ratios on survival.Results. Surgery with curative intent was performed in 497 patients; 136 (27%) died within the year. A CACI score of >4 was predictive of increased duration of stay (P < .001), postoperative complications (P = .042), and mortality within 1 year of pancreatic resection (P < .001). A CACI score of >= 6 increased 3-fold the odds of death within the first year.Conclusion. CACI is useful to predict outcome after pancreatectomy for pancreatic cancer. Patients a high CACI score have a