S. Hosseinzadeh1, P. Dutta3, R. Ganduboina4, M. Shariat1, I. Mukherjee2 1University Of Miami, General Surgery, Miami, FL, USA 2Staten Island University Hospital, Surgery, New York, NEW YORK, USA 3Kyiv Medical University, General Surgery, Kyiv, KYIV, Ukraine 4NRI Institute of Medical Sciences, General Surgery, Visakhapatnam, ANDHRA PRADESH, India
Introduction: Pancreatic cancer is the fourth leading cause of cancer-related deaths in the United States, with a 12% 5-year survival rate despite advances in treatment. Open pancreaticoduodenectomy is currently the only curative option for tumors in the pancreatic head and uncinate process and has improved survival rates. However, the procedure's complexity can result in relatively high mortality and morbidity during the perioperative period. Research has shown that advanced age doesn’t necessarily rule out patients from undergoing this surgery. This study further investigates how these findings apply to individuals with concomitant heart failure.
Methods: We conducted a retrospective analysis using NIS data from 2016 to 2021. The study focused on 224 heart failure patients who underwent a Whipple procedure for pancreatic cancer, identified using ICD-10 codes. The patients were divided into two groups: those under 75 years old (N = 134) and those 75 years and older (N = 90). We analyzed demographics, comorbidities, and outcomes.
Results: Most of the study population was between 60 and 80 years old. Both groups were primarily Caucasian males covered by Medicare, with the older group having higher comorbidity rates (Table 1). Interestingly, patients in the older group were significantly less likely to experience a myocardial infarction (MI) (OR 0.09, 95% CI 0.004-0.69, P = 0.04). However, their overall in-hospital mortality rate was not significantly different from that of the older group (P = 0.15). Adverse in-hospital outcomes were also similar across both age groups (P > 0.05).
Conclusion: The study found that in-hospital outcomes were similar between the two age groups, with median ages relatively close (younger group: 67 years, older group: 77.5 years). However, age is still an important factor in evaluating the suitability of pancreaticoduodenectomy for patients with heart failure. Our results suggest that although heart failure patients face significant surgical risks, the outcomes remain relatively acceptable, even among the elderly. Older patients experienced similar rates of adverse outcomes but had a lower likelihood of acute MI during their hospital stay. This finding warrants further investigation and could reflect either more selective criteria for older patients or a higher prevalence of valvular heart disease compared to unaddressed vascular issues in this group.