Mortality risk from PDAC surgery high in older adults

Older adults suffer from excess mortality risk from surgical resection for pancreatic ductal adenocarcinoma (PDAC), a recent study has shown.

Researchers conducted a retrospective analysis of 6,149 PDAC patients (mean age, 64.9±12.3 years; 50.4 percent male) who were hospitalized for pancreaticoduodenectomy. More than a fifth (21 percent) were at least 76 years of age. Two-hundred participants died, yielding a 30-day in-hospital mortality rate of 3.25 percent.

Stratifying according to age showed that the mean length of hospital stay was significantly longer in those who were >76 years of age than in their younger counterparts (14.5±10.9 vs 13.1±10.4 days; p<0.001). Patients stayed in the hospital for a mean of 13±11 days overall.

Multivariable analysis confirmed that age was significantly associated with a prolonged stay in the hospital (rate ratio [RR], 1.09, 95 percent confidence interval [CI], 1.04–1.14; p<0.001). The same was true for being male (RR, 1.08, 95 percent CI, 1.04–1.12; p<0.001) and having a history of prior illness (RR, 1.35, 95 percent CI, 1.29–1.41; p<0.001).

Similarly, 30-day in-hospital mortality rates were greater for patients >76 years of age (4.11 percent vs 2.77 percent). The corresponding rate in the overall cohort was 3.24 percent. This was likewise confirmed in multivariate analysis (odds ratio, 1.46, 95 percent CI, 1.07–2.00; p=0.016).

Though the present study is the largest of its kind examining mortality rates in older adults undergoing resection for PDAC, future studies are still required to better determine which of the elderly population derive the most benefit from pancreaticoduodenectomy, the researchers noted.