Preoperative Frailty and Risk of Post-ERCP Pancreatitis in Older Adults with Choledocholithiasis.
4 affiliations
- 1Department of Gastroenterology, Beijing Hospital, National Center for Gerontology, National Clinical Research Center for Gerontology, The Key Laboratory of Geriatrics of NHC, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, 100730, People's Republic of China.
- 2Department of Cardiology, Beijing Hospital, National Center for Gerontology; National Clinical Research Center for Gerontology; The Key Laboratory of Geriatrics of NHC; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
- 3Department of Geriatrics, Beijing Tongren Hospital, Capital Medical University, Beijing, People's Republic of China.
- 4Department of Gastroenterology, Beijing Hospital, National Center for Gerontology, National Clinical Research Center for Gerontology, The Key Laboratory of Geriatrics of NHC, Institute of Geriatric Medicine, Beijing, People's Republic of China.
Abstract
Background
Frailty is increasingly considered when evaluating surgical risk in older adults. However, evidence regarding whether frailty contributes to the risk of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis in elderly patients is limited.Objective
We aimed to evaluate whether preoperative frailty was associated with the development of post-ERCP pancreatitis (PEP) in elderly patients undergoing ERCP.Methods
Patients aged 65 years or older who underwent ERCP for choledocholithiasis were retrospectively included. Frailty was assessed preoperatively using an electronic health record-based composite frailty index (EHR-CFI). PEP was defined according to the Cotton consensus criteria. Multivariable logistic regression, receiver operating characteristic (ROC) analysis, and net reclassification improvement (NRI) were used to explore the incremental contribution of frailty to PEP risk stratification.Results
Among 696 patients, 79 (11.4%) developed PEP. After multivariable adjustment, frailty was associated with higher odds of PEP (OR = 2.09, 95% CI 1.08-4.05; P = 0.028). Adding frailty to a reference model containing difficult biliary cannulation (DBC), sex, age, and the Charlson Comorbidity Index (CCI) improved discrimination for PEP, with the AUC increasing from 0.714 to 0.755 (DeLong test P = 0.031). The NRI was 0.516 (95% CI 0.218-0.748), suggesting improved risk classification.Conclusion
Preoperative frailty assessed using EHR-CFI was independently associated with PEP and may provide additional value for risk stratification in elderly patients with choledocholithiasis undergoing ERCP.
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BibTeX
@article{zhang2026preoperative,
title = {{Preoperative Frailty and Risk of Post-ERCP Pancreatitis in Older Adults with Choledocholithiasis.}},
author = {Fan Zhang and Min Zeng and Yuhao Wan and Rui Gang and YuJun Xiong and XiaoYun Qin and Qingfeng Luo},
journal = {Clinical interventions in aging},
year = {2026},
month = oct,
doi = {10.2147/cia.s595446},
url = {https://europepmc.org/article/MED/42904120},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Preoperative Frailty and Risk of Post-ERCP Pancreatitis in Older Adults with Choledocholithiasis.
AU - Fan Zhang
AU - Min Zeng
AU - Yuhao Wan
AU - Rui Gang
AU - YuJun Xiong
AU - XiaoYun Qin
AU - Qingfeng Luo
PY - 2026
DA - 2026/10/16
JO - Clinical interventions in aging
DO - 10.2147/cia.s595446
UR - https://europepmc.org/article/MED/42904120
AB - Background Frailty is increasingly considered when evaluating surgical risk in older adults. However, evidence regarding whether frailty contributes to the risk of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis in elderly patients is limited.Objective We aimed to evaluate whether preoperative frailty was associated with the development of post-ERCP pancreatitis (PEP) in elderly patients undergoing ERCP.Methods Patients aged 65 years or older who underwent ERCP for choledocholithiasis were retrospectively included. Frailty was assessed preoperatively using an electronic health record-based composite frailty index (EHR-CFI). PEP was defined according to the Cotton consensus criteria. Multivariable logistic regression, receiver operating characteristic (ROC) analysis, and net reclassification improvement (NRI) were used to explore the incremental contribution of frailty to PEP risk stratification.Results Among 696 patients, 79 (11.4%) developed PEP. After multivariable adjustment, frailty was associated with higher odds of PEP (OR = 2.09, 95% CI 1.08-4.05; P = 0.028). Adding frailty to a reference model containing difficult biliary cannulation (DBC), sex, age, and the Charlson Comorbidity Index (CCI) improved discrimination for PEP, with the AUC increasing from 0.714 to 0.755 (DeLong test P = 0.031). The NRI was 0.516 (95% CI 0.218-0.748), suggesting improved risk classification.Conclusion Preoperative frailty assessed using EHR-CFI was independently associated with PEP and may provide additional value for risk stratification in elderly patients with choledocholithiasis undergoing ERCP.
SN - 1176-9092
SN - 1178-1998
ER -