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Objective:To study the risk factors for complications after endoscopic retrograde cholangiopancreatography (ERCP) in super-aged patients (≥80 years).Methods:Clinical data of 512 super-aged patients with pancreaticobiliary diseases who underwent 638 ERCP procedures at the Digestive Endoscopy Center, Zhongnan Hospital of Wuhan University, from July 2011 to June 2021, were studied retrospectively. Indications and results of the ERCP operations were analyzed. Multivariate logistic regression model was used to analyze the risk factors for ERCP-related complications.Results:The total success rate of ERCP cannulation in super-aged patients was 94.0% (600/638), which showed no difference compared with that of patients of <60 years old (2 433/2 557, 95.2%) or patients of 60~<80 years old (2 815/3 004, 93.7%) ( χ2=5.49, P=0.064). The overall incidence of post-ERCP complications was 15.2% (97/638), and the in-hospital mortality was 2.1% (11/512), which showed significant difference compared with patients of <60 years old (8/1 809, 0.4%) and patients of 60-<80 years old (21/2 127, 1.0%) ( χ2=13.39, P=0.002). Multivariate regression analysis showed that hypertension ( HR=1.94, 95% CI: 1.237-3.041, P=0.004), history of upper gastrointestinal reconstruction ( HR=2.28, 95% CI: 1.064-4.891, P=0.034), endoscopic sphincterectomy ( HR=1.65, 95%CI: 1.012-2.679, P=0.045), early procedure period ( HR=0.57, 95% CI: 0.352-0.923, P=0.022), operation time >30 minutes ( HR=1.74, 95% CI: 1.094-2.759, P=0.019), preoperative white blood cell count >9.5×10 9/L ( HR=2.66, 95% CI: 1.661-4.257, P<0.001) and procalcitonin ≥0.05 ng/L ( HR=2.54, 95% CI: 1.172-5.513, P=0.018) were independent risk factors for post-ERCP complications. Conclusion:ERCP is safe and effective for super-aged patients. However, much attention should be paid to post-ERCP complications of patients with hypertension, history of upper gastrointestinal reconstruction, endoscopic sphincterectomy, operation time >30 minutes, preoperative white blood cell count >9.5×10 9/L and procalcitonin ≥0.05 ng/L to avoid serious adverse events such as mortality.
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Objective@#To explore the effects of multidisciplinary team based nursing intervention on nutritional status, muscle strength, physical function and daily living ability of super-aged patients with sarcopenia.@*Methods@#A total of 29 super-aged patients with sarcopenia from July to November in 2017 in Department of Geriatric, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School were selected as the observation group with multidisciplinary team intervention. And 29 super-aged patients with sarcopenia from February to June 2017 were selected as the control group with routine management. Nutritional indicators, muscle strength, physical activity function and daily living ability scores were compared between the two groups at 1 and 6 months after intervention.@*Results@#After 1 month of intervention, hemoglobin and serum albumin was (118.79±11.47), (35.86±5.73) g/Lin the observation group and (112.27±11.69), (31.35±5.48) g/L in the control group, the difference between the two groups was statistically significant (t value was 2.09, 2.98, P<0.05 or 0.01). After 6 months of intervention, hemoglobin, serum albumin, muscle strength, physical activity function and daily living ability was (124.66±13.52) g/L, (38.47±6.02) g/L, (23.75±3.61) g, (9.18±1.85) points, (86.19±14.36) points in the observation group, and (112.03±11.89) g/L, (31.01±5.91) g/L, (19.15±3.19) g, (6.14±1.69) points, (64.12±15.83) points in the control group, the difference between the two groups was statistically significant (t value was 3.68-6.37, all P<0.01).@*Conclusions@#Nursing intervention based on multidisciplinary team can improve the nutritional status, muscle strength,physical function and quality of life of super-aged patients with sarcopenia.