The Potential Impact of Aortic Stenosis on in-Hospital Mortality in Patients With Pancreatic Cancer Undergoing Pancreaticoduodenectomy: A Nationwide Analysis

Background: Patients with aortic stenosis (AS) undergoing non-cardiac surgery, poses a management dilemma to physicians as they are at an increased risk for complications. This study aims to investigate the potential effect of AS on in-hospital mortality and other complications in patients with pancreatic cancer undergoing pancreaticoduodenectomy (PD). Methods: In this retrospective study, we investigated patients with pancreatic cancer undergoing PD between 2016 to 2019 using the National Inpatient Sample (NIS) database. The study population was divided into two groups based on the presence and absence of AS. Multivariate logistic regression analyses were performed to determine factors associated with in-hospital mortality, mechanical ventilation, cardiac arrest, vasopressor use, and intensive care unit (ICU) admission. Odds ratio (OR) at 95% confidence interval (CI) was used to describe the association between the study and outcome variables. Results: Of the 16,150 patients with pancreatic cancer underwent PD, 165 patients were diagnosed with AS. The mean age of patients with AS underwent PD was significantly higher than patients without AS. Patients with AS had a significantly higher in-hospital mortality, cardiac arrest, and ICU admission compared to patients without AS. There was no difference in the mechanical ventilation usage, hospital charges, and length of stay between the two groups. ConclusionAS was found to be associated with higher in-hospital mortality and worse outcomes in pancreatic cancer patients undergoing PD. A multidisciplinary team involving surgeons, cardiologists, anaesthesiologists, and physician should work together to jointly develop an appropriate preoperative and postoperative approach and management for these patients.