Comorbidity burden and outcomes of endoscopic ultrasound‐guided treatment of pancreatic fluid collections: Multicenter study with nationwide data‐based validation
Year: 2024
Type: article
Study design: Observational Study
Abstract: Objectives The appropriate holistic management is mandatory for successful endoscopic ultrasound (EUS)‐guided treatment of pancreatic fluid collections (PFCs). However, comorbidity status has not been fully examined in relation to clinical outcomes of this treatment. Methods Using a multi‐institutional cohort of 406 patients receiving EUS‐guided treatment of PFCs in 2010–2020, we examined the associations of Charlson Comorbidity Index (CCI) with in‐hospital mortality and other clinical outcomes. Multivariable logistic regression analysis was conducted with adjustment for potential confounders. The findings were validated using a Japanese nationwide inpatient database including 4053 patients treated at 486 hospitals in 2010–2020. Results In the clinical multi‐institutional cohort, CCI was positively associated with the risk of in‐hospital mortality (Ptrend < 0.001). Compared to patients with CCI = 0, patients with CCI of 1–2, 3–5, and ≥6 had adjusted odds ratios (95% confidence intervals) of 0.76 (0.22–2.54), 5.39 (1.74–16.7), and 8.77 (2.36–32.6), respectively. In the nationwide validation cohort, a similar positive association was observed; the corresponding odds ratios (95% confidence interval) were 1.21 (0.90–1.64), 1.52 (0.92–2.49), and 4.84 (2.63–8.88), respectively (Ptrend < 0.001). The association of higher CCI with longer length of stay was observed in the nationwide cohort (Ptrend < 0.001), but not in the clinical cohort (Ptrend = 0.18). CCI was not associated with the risk of procedure‐related adverse events. Conclusions Higher levels of CCI were associated with a higher risk of in‐hospital mortality among patients receiving EUS‐guided treatment of PFCs, suggesting the potential of CCI in stratifying the periprocedural mortality risk. Trial registration The research based on the clinical data from the WONDERFUL cohort was registered with UMIN‐CTR (registration number UMIN000044130).
Source: Digestive Endoscopy
DOI: 10.1111/den.14924
Authors: Tsuyoshi Hamada, Atsuhiro Masuda, Nobuaki Michihata, Tomotaka Saito, Masahiro Tsujimae, Mamoru Takenaka, Shunsuke Omoto, Takuji Iwashita, Shinya Uemura, Shogo Ota, Hideyuki Shiomi, Toshio Fujisawa, Sho Takahashi, Saburo Matsubara, Kentaro Suda, Hiroki Matsui, Akinori Maruta, Kensaku Yoshida, Keisuke Iwata, Mitsuru Okuno, Nobuhiko Hayashi, Tsuyoshi Mukai, Kiyohide Fushimi, Ichiro Yasuda, Hiroyuki Isayama, Hideo Yasunaga, Yousuke Nakai, the WONDERFUL study group in Japan and collaborators
Institutions: The Cancer Institute Hospital, Japanese Foundation For Cancer Research, The University of Tokyo, Kobe University, Kindai University, Gifu University Hospital, Hyogo Medical University, Juntendo University, Saitama Medical Center, Saitama Medical University, Gifu Prefectural General Medical Center, Gifu Municipal Hospital, University of Toyama, Kanazawa Medical University, Tokyo Medical and Dental University, University of Tokyo Hospital
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,600
OpenAlex ID: W4402890712