Association Between Charlson Comorbidity Index and Complications of Endoscopic Resection of Gastric Neoplasms in Elderly Patients

Association Between Charlson Comorbidity Index and Complications of Endoscopic Resection of Gastric Neoplasms in Elderly Patients | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research article Association Between Charlson Comorbidity Index and Complications of Endoscopic Resection of Gastric Neoplasms in Elderly Patients Sunmin Kim, Dong Hyun Kim, Seon-Young Park, Chang Hwan Park, Hyun Soo Kim, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.2.16786/v2 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 09 Jul, 2020 Read the published version in BMC Gastroenterology → Version 2 posted 9 You are reading this latest preprint version Show more versions Abstract Background: Although endoscopic resection is safe and effective for gastric epithelial neoplasms, information is limited on its efficacy and safety in extremely elderly patients who have various comorbidities. Further, the relationship between comorbidities and complications of endoscopic resection is not well established. Therefore, we aimed to evaluate the efficacy and safety of endoscopic resection of gastric epithelial neoplasms in extremely elderly patients. Methods: From October 2008 to December 2017, 4475 consecutive patients underwent endoscopic resection of gastric epithelial neoplasms. Among them, 242 were 75 years or older. We assessed Charlson comorbidity index (CCI) scores, procedural outcomes, and procedure- and sedation-related complications related to endoscopic resection. Results: Mean patient age was 78.7 ± 3.2 years. Of the 242 patients, 124 (51.2%) had low-grade dysplasia and 112 (46.3%) had adenocarcinoma. The most common comorbidity was hypertension (55.4%), followed by diabetes (23.1%). The mean CCI score was 1.67 ± 1.43. Sixty patients (24.8%) had a CCI score ≥ 3. During the procedure, 10 (4.1%) patients had desaturation that recovered by flumazenil use with mask (n=2) or Ambu bag (n=3) ventilation. During subsequent admission, atelectasis or pneumonia occurred in 45 (18.6%) patients, post-procedural bleeding in 12 (5.0%), and perforation in 3 (1.2%). Respiratory complications were more common in patients with a CCI score ≥ 3 (20/60, 33.3%) than in those with a CCI score < 3 (25/182, 13.7%, P=0.002). Conclusions: CCI score is related to respiratory complications of endoscopic resection in extremely elderly patients. Endoscopic resection must be performed cautiously, particularly in elderly patients with a high CCI score, to prevent respiratory complications. Gastroenterology & Hepatology Endoscopic mucosal resection Aged Comorbidity Stomach neoplasms Figures Figure 1 Figure 2 Figure 3 Background Endoscopic resection is safe and effective for the treatment of gastric epithelial neoplasms and has a low risk of procedure-related complications [1-3]. In increasingly aged societies, a growing number of endoscopic treatments are performed for the elderly, and several reports have shown contrasting treatment outcomes and complications of endoscopic resection in elderly and non-elderly patients [4-8]. Elderly patients, especially those aged 75 years or older (extremely elderly patients), have various comorbidities and functional disabilities that influence daily life [9, 10]. Although several studies have reported that endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are safe and reliable in the elderly [4-8], endoscopy itself carries risks in elderly patients, particularly those with renal or respiratory comorbidities [11, 12]. In the real-world clinical setting, endoscopists must consider comorbidities, performance status, and expected survival in elderly patients. The relationship between comorbidities and complications of endoscopic resection in elderly patients is not well established. The Charlson comorbidity index (CCI) has been widely utilized to measure the burden of complex comorbidities by health researchers [13]. The CCI predicts mortality by classifying or weighting comorbidities and has been validated in various disease subgroups, including stroke, cardiac disease, renal disease, and liver disease [14-17]. However, no studies to date have examined the relationship between CCI score and incidence of complications after endoscopic resection of gastric epithelial neoplasms in elderly patients. Here we aimed to evaluate the CCI and efficacy and safety of endoscopic resection of gastric epithelial neoplasms in extremely elderly patients. Methods Study population This retrospective study was conducted in accordance with the Ethical Guidelines of the Declaration of Helsinki. This study was approved by the Institutional Review Board of Chonnam National University Hospital (no. CNUH-2018-236). From October 2008 to December 2017, a total of 4475 consecutive patients underwent endoscopic resection of gastric epithelial neoplasms in our center. Among them, 242 aged 75 years or older were included in this study. The patients underwent ESD or EMR for gastric epithelial neoplasms. We reviewed their medical records and extracted information about their demographic and clinical characteristics, procedural outcomes, and procedure- or sedation-related complications. Assessment of CCI scores before endoscopic procedure The components of CCI include: previous myocardial infarction, congestive cardiac failure, peripheral vascular disease, cerebrovascular accident, dementia, chronic obstructive pulmonary disease, connective tissue disease, peptic ulcer disease, diabetes, renal disease, hemiplegia, leukemia, lymphoma, solid tumor with or without metastatic disease, liver disease, and acquired immunodeficiency syndrome status. We calculated the CCI by summing the weights of all comorbid parameters. The total CCI score was 0-33. We divided the patients into those with a CCI < 3 and those with a CCI ≥ 3. Performance status We reviewed the patients’ medical records to investigate their social history, body mass index, and comorbidities. Based on these data, the performance status of all enrolled patients was evaluated using the American Society of Anesthesiologists-Performance Status and Eastern Cooperative Oncology Group-Performance Status. Endoscopic procedure Endoscopists determined the methods of removal for the lesions (EMR or ESD) according to shape, size, presence of fibrosis, or presence of lesion ulceration before endoscopic resection. For ESD or EMR, patients were placed in the left lateral decubitus position. Each endoscopic procedure was performed using a single-channel upper gastrointestinal endoscope with transparent hood under CO 2 insufflation. Anticoagulants or antiplatelet agents Anticoagulant and antiplatelet agent therapy was discontinued for endoscopic resection according to the recommended cessation period [18]. The endoscopic procedure was evaluated as a high risk procedure that could cause bleeding, and the discontinuation of the drug was determined individually according to the patient's pre-existing thromboembolic condition. Anesthesia procedure All procedures were performed with use of endoscopist-directed sedation. Patients were sedated with midazolam and pethidine with or without propofol. The target sedation level was mild to moderate [19]. For sedation induction, midazolam 3 mg and pethidine 25 mg were intravenously injected. Thereafter, additional propofol, midazolam, or pethidine was intravenously injected to ensure adequate sedation or pain control. Oxygen was supplied at a constant level of 2 L/min via a nasal prong during the procedure, and sedative medication doses were adjusted according to the vital signs of patients. We monitored blood pressure, heart rate, and oxygen saturation during the procedure. Outcome Measures The primary outcome was procedure- and sedation-related complications, while the secondary outcomes were procedure time and complete resection rate. Procedure-related complications Procedure-related bleeding was defined as bleeding requiring transfusion or emergency endoscopy or that reduced the hemoglobin level by more than 2 g/dL following the procedure. We defined immediate bleeding as bleeding occurring within 24 hours after the endoscopic resection and delayed bleeding as gastrointestinal bleeding occurring later than 24 hours after the endoscopic resection [20, 21]. Procedure-related perforation was defined as endoscopically observed extraluminal space or intra-abdominal free air on chest radiography taken after the procedure [21]. Sedation-related complications Sedation-related complications were divided into immediate complications (hypotension, arrhythmia, hypoxia) during endoscopy and post-procedural complications (respiratory complications such as atelectasis and pneumonia). Hypotension during the procedure was defined as systolic blood pressure below 90 mmHg. Oxygen desaturation was defined as oxygen arterial saturation 90%. Bradycardia was defined as any episode of heart rate < 40 beats per minute. All patients underwent pre-procedure chest radiography at the time of admission. Atelectasis was diagnosed by comparison of post-procedure and pre-procedure chest radiographic findings, regardless of clinical symptoms. Radiographic findings of atelectasis include direct signs such as crowding of pulmonary vessels, crowed air bronchogram, and displacement of interlobar fissure as well as indirect signs such as pulmonary opacification and elevation of the ipsilateral diaphragm. Pneumonia was defined as newly developed pulmonary infiltration with clinical symptoms such as cough, sputum, and fever with chilling. In these cases, proper antibiotics were administered. Procedure time Procedure time was defined as the time from the start of intravenous administration of the sedative agent to the time of endoscope extubation. Complete resection Complete resection was defined as follows: 1) tumor removed in one piece (en bloc resection) and horizontal/vertical margin was histologically free from tumorous glands; or 2) tumor removed in multiple pieces (piecemeal resection) and follow-up endoscopy revealed no recurrence for at least 1 year. Follow up endoscopy Follow-up endoscopy was performed 3-6 months after endoscopic resection, and follow-up endoscopy was performed every year thereafter. We defined tumor recurrence as local recurred or metachronous lesions in the stomach after 1 year after endoscopic resection of the primary lesion. Statistical analysis Statistical analysis was performed using SPSS version 23.0 (SPSS Inc., Chicago, IL, USA). Continuous data are shown as mean ± standard deviation or median (range), while categorical data are shown as absolute and relative frequencies. Continuous variables were analyzed using Student’s t-test. Categorical data were examined using Fisher’s exact test or the chi-squared test. On multivariate analysis, binary logistic regression models with forward conditioning were used to investigate CCI-associated complications. The data included in the regression analysis are presented as crude or adjusted odds ratios with 95% confidence intervals (CIs). Variables with P values < 0.05 on the univariate analysis were selected for inclusion in the multivariate analysis. Results Patient demographics The mean patient age was 78.7 ± 3.2 years. Of the 242 patients, 124 (51.2%) had low-grade dysplasia and 112 (46.3%) had carcinoma in situ or adenocarcinoma (Table 1). The most common comorbidity was hypertension (55.4%), followed by diabetes (23.1%) (Table 2). A total of 141 (58.3%) patients underwent ESD. Seventy-one (31%) patients underwent endoscopic resection of multiple lesions in a single session. The mean procedure time was 34.9 ± 23.7 minutes, and the mean hospital stay was 5.0 ± 1.7 days. Midazolam was used in all patients and propofol was used in 215 (88.8%) patients. Charlson comorbidity index The mean CCI score was 1.67 ± 1.43 (range, 0-7). Figure 1 shows the distribution of the CCI score in the 242 patients: 59 (24.4%) had a CCI score of 0, 65 (26.9%) had a CCI score of 1, 58 (24.0%) had a CCI score of 2, 29 (12.0%) had a CCI score of 3, 23 (9.5%) had a CCI score of 4, 6 (2.5%) had a CCI score of 5, 1 (0.4%) had a CCI score of 6, and 1 (0.4%) had a CCI score of 7. Thus, 182 patients had a low CCI score (<3) and 60 had a high CCI score (≥3). Procedure-related complications Procedure-related complications included immediate bleeding (4.1%), delayed bleeding (0.8%) and perforation (1.2%). There were no significant differences in procedure-related complications between the low and high CCI groups. Sedation-related complications During the procedure, there were 10 (4.1%) patients with desaturation recovered by flumazenil with use mask (n = 2) or Ambu bag (n = 3) ventilation. No patient received endotracheal intubation during endoscopic procedure. There were no significant differences in the incidence of hypotension or hypoxia during the procedure between the low and high CCI groups. Post-procedural complications such as atelectasis or pneumonia occurred in 45 (18.6%) patients. In 4 patients, pneumonia was diagnosed due to fever, respiratory symptoms, and chest radiography abnormalities. These patients were treated with antibiotics and improved without sequelae. Most other patients improved spontaneously during the outpatient follow-up period (Figure 2). The incidence of respiratory complications such as atelectasis or pneumonia tended to increase with CCI score: 20.3% (n = 12/59) in patients with a score of 0, 9.2% (n = 6/65) in patients with a score of 1, 12.1% (n = 7/58) in patients with a score of 2, 34.5% (n = 10/29) in patients with a score of 3, 39.1% (n = 9/23) in patients with a score of 4, and 12.5% (n = 1/8) in patients with a score of 5 or more (Figure 3). The incidence of atelectasis was 20/60 (33.3%) in patients with a CCI score ≥3 and 21/182 (11.5%) in patients with a CCI score < 3 (P<0.01). Post-procedural pneumonia developed only in 4 patients of CCI<3. The incidence of respiratory complications (atelectasis or pneumonia) was higher in the group with a CCI score ≥ 3 (Table 3). Uni- and multivariate analyses showed that age and presence of a CCI score ≥ 3 were related to the incidence of atelectasis or pneumonia after endoscopic resection in extremely elderly patients. The adjusted odds ratio for patients with a CCI score ≥ 3 and the development of atelectasis or pneumonia was 3.103 (95% CI, 1.538 – 6.261, Table 4). Clinical outcomes En bloc resection was achieved in 90.5% (219/242) of patients, while complete resection was achieved in 87.2% (211/242) of patients. Among 31 patients with incomplete resection, 12.9% (4/31) patients underwent additional operation and 3.2% (1/31) underwent additional endoscopic resection. There was no significant difference in the en bloc resection or complete resection rates between the patients with low and high CCI scores (Table 3). Tumor recurrence occurred in 3.8% (8/211) patients with complete resection. . Discussion Our study demonstrated that: (1) endoscopic resection was effective and safe for extremely elderly (≥75 years of age) patients with gastric neoplasms under careful consideration; and (2) age and higher CCI score (≥3) were independent risk factors for atelectasis or pneumonia after endoscopic resection in extremely elderly patients. Several studies have examined the treatment outcomes and safety of endoscopic resection in elderly patients, which showed no significant difference in treatment outcomes of endoscopic resection of early gastric cancer in elderly patients [4-6]. In our study including extremely elderly patients, the en bloc resection rate was 90.5% and the complete resection rate was 87.2%, similar to the rates reported in previous studies [4, 7, 20, 21]. Procedure-related bleeding and procedure-related perforation was observed in 4.9% and 0.4% of extreme elderly patients, respectively. These complication rates were comparable in those of other studies including elderly or non-elderly patients [7, 20]. Sedation-related complications such as intra-procedural hypotension and oxygen desaturation is known to be occurred more frequently in elderly patients[20, 22]. Furthermore, post-procedural respiratory complications such as atelectasis or pneumonia developed more frequently in elderly patients than in nonelderly patients [7, 20]. Tokioka et al. demonstrated that recovery time from respiratory complications was longer and performance score was higher after endoscopic resection of early gastric cancer in patients aged 65 years and older [4]. In our study, significant hypoxemia occurred in 4.1% and post-procedural respiratory complications occurred in 18.6% (atelectasis in 16.9% and pneumonia in 1.7%). Development of atelectasis in perioperative patients is associated with decreased lung compliance and increased pulmonary vascular resistance leading to lung injury and impairment of oxygenation [23]. Even though most patients with atelectasis recovered with conservative treatment in this study, persistent prolonged atelectasis after anesthesia is known to increase perioperative respiratory complications leading to significant consequence, especially in patients with underlying lung disease or cardiopulmonary dysfunction [23-26]. Therefore, early detection of atelectasis and effort for reversal of atelectasis in those patients may prevent significant periprocedural respiratory complication and improve clinical outcomes. In recent studies, respiratory complication after endoscopic resection was found to be significantly related to the procedure time, the degree of sedation, and the amount of propofol use [27, 28]. In our study, respiratory complication tended to increase with increasing procedure time, but it was not statistically significant. In addition, there was no correlation between the use of propofol or the dose used, and an increase in respiratory complication. Charlson et al developed a scoring system to classify prognostic comorbidity and predict in-hospital and 1-year mortality rates [13]. Several studies reported that CCI predicted the prognosis of various diseases such as ischemic stroke [14], end-stage renal disease [15], cirrhosis [17], and lung cancer [29]. It could be adapted to patients in health care [30] and post-operative outcomes in acute cholecystitis [31]. In our study, CCI score was not related to procedure-related complications or immediate sedation-related complications such as hypoxemia or hypotension. However, post-procedural complications including atelectasis/pneumonia were frequently observed in extremely elderly patients with higher a CCI score (≥3). Therefore, we expect to apply CCI score to other advanced endoscopic procedures including endoscopic retrograde cholangio-pancreatography, endoscopic ultrasonography-guided intervention, submucosal tunneling endoscopic resection or enteroscopy in elderly patients to evaluate the risk for periprocedural complications. This study has several limitations; first, this study might not have included patients with very severe or uncontrolled comorbidities due to its retrospective design. All enrolled patients could be selected since they were considered suitable candidates for endoscopic therapy by the endoscopist. However, it is not possible to design a prospective study that enrolls only patients with severe morbidities due to ethical concerns. Second, we could not get the information for effect of sedative agents, as clinician choose the sedative agents for the procedure according to risk assessment of procedural complication. Conclusions In conclusion, although endoscopic resection is considered safe and effective for elderly patients, endoscopists must perform it cautiously, particularly in extremely elderly patients with a high CCI score, to prevent post-procedural respiratory complications such as pneumonia or atelectasis. In the future, we need to conduct a study to prevent postprocedural respiratory complication Abbreviations CCI Charlson comorbidity index EMR endoscopic mucosal resection ESD endoscopic submucosal dissection Declarations Ethics approval and consent to participate: Ethics Committee of the Chonnam National University Hospital approved this current study. CNUH-2018-236). Consent for publication : Not Applicable Availability of data and material : The datasets used and/or analyzed during the current study available from the corresponding author on request. Competing interests : The authors have no conflicts of interests Funding: This study was supported by the Chonnam National University Hospital Research Institute of Clinical Medicine (CRI 14011-1 and B2019-1047). This funding source had no role in the design of this study and collection, analysis and interpretation of data and in writing the manuscript. Authors' contributions: All authors have read and approved this manuscript. SK analyzed electronic medical records and drafted a manuscript. DHK developed the concept of study, analyzed of electronic medical records, and wrote manuscript. SK and DHK contributed equally as co-first authors. SYP made substantial contributions to the conception and design of the study, interpreted data, wrote the paper and revised it critically for intellectual contents. CHP, HSK, SKC and JSR performed the literature review and collected clinical data. All authors (SK, DHK, SYP, CHP, HSK, SKC and JSR) have read and approved the final manuscript. 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Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver 2019, 51 (6):858-863. Tables Table 1. Endoscopic and histologic findings in 242 elderly patients Variables Number of lesions, n (%) Single 166 (68.6) Multiple 76 (31.4) Location of lesion, n (%) Upper 1/3 28 (11.5) Mid 1/3 78 (32.2) Lower 1/3 136 (56.2) Macroscopic appearance, n (%) Flat/depressed 67 (27.7) Elevated 175 (72.3) Histologic findings, n (%) Low-grade dysplasia 124 (51.2) Carcinoma in situ or adenocarcinoma 112 (46.3) Other 6 (2.5) Method of endoscopic resection, n (%) EMR 100 (41.3) ESD 142 (58.7) Mean procedure time, min, mean ± SD 34.9 ± 23.7 Method of Sedation Midazolam + Propofol+ Pethidine 215 (88.8) Midazolam + Pethidine 27 (11.2) Dose of sedative agents, mean ± SD Midazolam, mg 3.43 ± 1.16 Propofol, mg 112.0 ± 88.0 EMR, endoscopic mucosal resection; ESD, endoscopic submucosal dissection; SD, standard deviation Table 2. Baseline characteristics and comorbidities of elderly patients who underwent endoscopic resection Variables Age, yrs, mean ± SD 78.7 ± 3.2 Female sex, n (%) 101 (41.7) Body mass index, kg/m 2 , mean ± SD 23.7 ± 3.3 Comorbidities, variable CCI, n (%) Weighting Acute myocardial infarction 1 30 (12.4) Congestive heart failure 1 11 (4.5) Peripheral vascular disease 1 3 (1.2) Cerebrovascular accident 1 11 (4.5) Dementia 1 5 (2.1) Chronic pulmonary disease 1 27 (11.2) Connective tissue disease 1 0 (0) Ulcer disease 1 0 (0) Mild liver disease 1 13 (5.4) Hepatitis 8 (3.3) Diabetes 1 56 (23.1) Diabetes with end organ damage 2 0 (0) Hemiplegia 2 0 (0) Moderate or severe renal disease 2 3 (1.2) Any tumor 2 31 (12.8) Leukemia 2 0 (0) Lymphoma 2 0 (0) Moderate to severe liver disease 3 5 (2.1) Metastatic solid tumor 6 0 (0) Acquired immunodeficiency syndrome 6 0 (0) Charlson comorbidity index, mean ± SD 1.67 ± 1.43 ASA-PS, mean ± SD 2.01 ± 0.49 ECOG-PS, mean ± SD 1.55 ± 0.55 Medication, n (%) Aspirin 70 (28.9) Clopidogrel 10 (4.1) Antithrombotic agents 1 (0.4) SD, standard deviation; ASA-PS, American Society of Anesthesiologists Performance Status; CCI, Charlson comorbidity index , ECOG-PS, Eastern Cooperative Oncology Group Performance Status Table 3. Treatment outcomes and complications by CCI score CCI < 3 (n =182) CCI ≥ 3 (n =60) P value Age, mean ± SD 78.6 ± 3.1 79.0 ± 3.3 0.38 Sex (female) 81 (44.5) 20 (33.3) 0.13 Procedure time, min, median (range) 30 (4 ~150) 25 (5 ~120) 0.05 Resectability, n (%) En bloc resection 161 (88.5) 58 (96.7) 0.06 Piecemeal resection 21 (11.5) 2 (3.3) Method of sedation, n (%) Midazolam + Pethidine + Propofol 160 (87.9) 55 (91.7) 0.42 Midazolam + Pethidine 22 (12.1) 5 (8.3) Dose of sedative agents, mean ± SD Midazolam, mg 3.65 ± 0.95 3.39 ± 0.87 0.07 Propofol, mg 126.4 ± 79.2 132.6 ± 92.5 0.64 Procedure-related complications, n (%) Immediate bleeding 10 (5.5) 0 0.06 Delayed bleeding 2 (1.1) 0 0.42 Perforation 3 (1.6) 0 0.32 Sedation-related complications, n (%) Immediate complication Hypotension 1 (0.5) 0 0.57 Arrhythmia 37 (20.3) 14 (23.3) 0.62 Hypoxia 8 (4.4) 2 (3.3) 0.72 Hypopnea or apnea 1 (0.5) 0 0.57 Delayed complication Atelectasis 21 (11.5) 20 (33.3) <0.01 Pneumonia 4 (2.2) 0 (0) 0.25 Atelectasis or Pneumonia 25 (13.7) 20 (33.3) <0.01 CCI, Charlson comorbidity index Table 4. Univariate and multivariate analysis for predicting atelectasis/pneumonia after endoscopic resection in elderly patients Variables cOR (95% CI) P value aOR (95% CI) P value Age, yrs 1.175 (1.065 – 1.296) 0.001 1.173 (1.061 – 1.297) 0.002 Sex (female) 0.781 (0.408 – 1.498) 0.458 Body mass index, kg/m 2 0.999 (0.904 – 1.105) 0.987 CCI ≥ 3 3.140 (1.586 – 6.215) 0.001 3.103 (1.538 – 6.261) 0.002 Use of propofol 0.738 (0.242 – 2.251) 0.593 Procedure time, min 1.012 (1.000 – 1.025) 0.056 cOR, crude odds ratio; aOR, adjusted OR; CCI, Charlson comorbidity index Cite Share Download PDF Status: Published Journal Publication published 09 Jul, 2020 Read the published version in BMC Gastroenterology → Version 2 posted Editorial decision: Minor revision 23 Jun, 2020 Review # 1 received at journal 17 Jun, 2020 Reviewer # 2 agreed at journal 29 May, 2020 Review # 2 received at journal 29 May, 2020 Reviewers invited by journal 28 May, 2020 Reviewer # 1 agreed at journal 28 May, 2020 Editor assigned by journal 19 May, 2020 Submission checks completed at journal 18 May, 2020 Editor invited by journal 18 May, 2020 You are reading this latest preprint version Show more versions Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7424","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research article","associatedPublications":[],"authors":[{"id":594197,"identity":"6a7f2905-e2cd-42df-b261-fccd3688c4d6","order_by":1,"name":"Sunmin Kim","email":"","orcid":"https://orcid.org/0000-0003-0077-1924","institution":"Chonnam National University Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Sunmin","middleName":"","lastName":"Kim","suffix":""},{"id":594198,"identity":"78a96752-a0e3-4cef-adfa-f65c813f3a2b","order_by":2,"name":"Dong Hyun Kim","email":"","orcid":"","institution":"Chonnam National University Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Dong","middleName":"Hyun","lastName":"Kim","suffix":""},{"id":594199,"identity":"c21ed66a-05c3-476c-a8ad-59cb88c38551","order_by":3,"name":"Seon-Young Park","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAsElEQVRIiWNgGAWjYDCCAyCignQtZ0jWwthGig6+22cPf+add0fe4HjvA4YfFdsIa5E8l5cmzbvtmeGGM8cNGHvO3CasxeAMjxkz77bDjDNnpDEwM7YRp8X4M++cw/Yz5z8jXouBNG/D4cR+CTYitUie4UuTnHPscHI/TxrDQaL8wneG9/CHNzWHbdvYjzE++FFBhBYGBh4GJh4o8wAx6sFaGH8QqXQUjIJRMApGKAAA/Po7hAd0E5AAAAAASUVORK5CYII=","orcid":"","institution":"Chonnam National University Hospital","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Seon-Young","middleName":"","lastName":"Park","suffix":""},{"id":594200,"identity":"8d427fd6-90fb-44b6-a3ea-66234f689de0","order_by":4,"name":"Chang Hwan Park","email":"","orcid":"","institution":"Chonnam National University Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Chang","middleName":"Hwan","lastName":"Park","suffix":""},{"id":594201,"identity":"10a520d1-b0ac-420f-9eaa-c1c7bb7c69d8","order_by":5,"name":"Hyun Soo Kim","email":"","orcid":"","institution":"Chonnam National University Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Hyun","middleName":"Soo","lastName":"Kim","suffix":""},{"id":594202,"identity":"e1048ca4-a9c0-4fc4-888b-7229cb67e885","order_by":6,"name":"Sung Kyu Choi","email":"","orcid":"","institution":"Chonnam National University Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Sung","middleName":"Kyu","lastName":"Choi","suffix":""},{"id":594203,"identity":"bf08a215-90ff-4325-b393-453791ef259f","order_by":7,"name":"Jong Sun Rew","email":"","orcid":"","institution":"Chonnam National University Hospital","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Jong","middleName":"Sun","lastName":"Rew","suffix":""}],"badges":[],"createdAt":"2019-10-31 14:18:35","currentVersionCode":2,"declarations":"","doi":"10.21203/rs.2.16786/v2","doiUrl":"https://doi.org/10.21203/rs.2.16786/v2","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12876-020-01360-6","type":"published","date":"2020-07-09T12:00:00+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":1203129,"identity":"3c938fb7-3c68-465e-8a10-b886e23a6ca8","added_by":"auto","created_at":"2020-05-29 02:06:07","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":27267,"visible":true,"origin":"","legend":"Percentage of patients by CCI score","description":"","filename":"1.PNG","url":"https://assets-eu.researchsquare.com/files/rs-7424/v2/1.PNG"},{"id":1203130,"identity":"7b48b5d4-6b62-4edc-a4eb-a5f39d9582a0","added_by":"auto","created_at":"2020-05-29 02:06:08","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":39101,"visible":true,"origin":"","legend":"One example of atelectasis in an elderly patient (79-year-old woman who underwent endoscopic submucosal dissection). Photo of procedure (A). X-ray before procedure (B) and 24 hours after the procedure (C).","description":"","filename":"2.PNG","url":"https://assets-eu.researchsquare.com/files/rs-7424/v2/2.PNG"},{"id":1203131,"identity":"4606ff19-bf79-4509-b49c-5d8236543df9","added_by":"auto","created_at":"2020-05-29 02:06:08","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":31891,"visible":true,"origin":"","legend":"Atelectasis occurrence by CCI score (Data are expressed as mean ± standard error).","description":"","filename":"3.PNG","url":"https://assets-eu.researchsquare.com/files/rs-7424/v2/3.PNG"},{"id":13533500,"identity":"ba5d998a-cae3-4dd2-8154-ee9cb2bbf936","added_by":"auto","created_at":"2021-09-17 01:21:12","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1207767,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7424/v2/bf247fcd-a7a2-4186-893c-f988103871a4.pdf"}],"financialInterests":"","formattedTitle":"Association Between Charlson Comorbidity Index and Complications of Endoscopic Resection of Gastric Neoplasms in Elderly Patients","fulltext":[{"header":"Background","content":"\u003cp\u003eEndoscopic resection is safe and effective for the treatment of gastric epithelial neoplasms and has a low risk of procedure-related complications [1-3]. In increasingly aged societies, a growing number of endoscopic treatments are performed for the elderly, and several reports have shown contrasting treatment outcomes and complications of endoscopic resection in elderly and non-elderly patients [4-8].\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Elderly patients, especially those aged 75 years or older (extremely elderly patients), have various comorbidities and functional disabilities that influence daily life [9, 10]. Although several studies have reported that endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are safe and reliable in the elderly [4-8], endoscopy itself carries risks in elderly patients, particularly those with renal or respiratory comorbidities [11, 12].\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; In the real-world clinical setting, endoscopists must consider comorbidities, performance status, and expected survival in elderly patients. The relationship between comorbidities and complications of endoscopic resection in elderly patients is not well established. The Charlson comorbidity index (CCI) has been widely utilized to measure the burden of complex comorbidities by health researchers [13]. The CCI predicts mortality by classifying or weighting comorbidities and has been validated in various disease subgroups, including stroke, cardiac disease, renal disease, and liver disease [14-17]. However, no studies to date have examined the relationship between CCI score and incidence of complications after endoscopic resection of gastric epithelial neoplasms in elderly patients.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Here we aimed to evaluate the CCI and efficacy and safety of endoscopic resection of gastric epithelial neoplasms in extremely elderly patients.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy population\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; This retrospective study was conducted in accordance with the Ethical Guidelines of the Declaration of Helsinki. This study was approved by the Institutional Review Board of Chonnam National University Hospital (no. CNUH-2018-236).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; From October 2008 to December 2017, a total of 4475 consecutive patients underwent endoscopic resection of gastric epithelial neoplasms in our center. Among them, 242 aged 75 years or older were included in this study. The patients underwent ESD or EMR for gastric epithelial neoplasms. We reviewed their medical records and extracted information about their demographic and clinical characteristics, procedural outcomes, and procedure- or sedation-related complications.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAssessment of CCI scores before endoscopic procedure\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; The components of CCI include: previous myocardial infarction, congestive cardiac failure, peripheral vascular disease, cerebrovascular accident, dementia, chronic obstructive pulmonary disease, connective tissue disease, peptic ulcer disease, diabetes, renal disease, hemiplegia, leukemia, lymphoma, solid tumor with or without metastatic disease, liver disease, and acquired immunodeficiency syndrome status. We calculated the CCI by summing the weights of all comorbid parameters. The total CCI score was 0-33. We divided the patients into those with a CCI \u0026lt; 3 and those with a CCI \u0026ge; 3.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePerformance status\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; We reviewed the patients\u0026rsquo; medical records to investigate their social history, body mass index, and comorbidities. Based on these data, the performance status of all enrolled patients was evaluated using the American Society of Anesthesiologists-Performance Status and Eastern Cooperative Oncology Group-Performance Status.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEndoscopic procedure \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Endoscopists determined the methods of removal for the lesions (EMR or ESD) according to shape, size, presence of fibrosis, or presence of lesion ulceration before endoscopic resection. For ESD or EMR, patients were placed in the left lateral decubitus position. Each endoscopic procedure was performed using a single-channel upper gastrointestinal endoscope with transparent hood under CO\u003csub\u003e2\u003c/sub\u003e insufflation.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAnticoagulants or antiplatelet agents\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAnticoagulant and antiplatelet agent therapy was discontinued for endoscopic resection according to the recommended cessation period [18]. The endoscopic procedure was evaluated as a high risk procedure that could cause bleeding, and the discontinuation of the drug was determined individually according to the patient's pre-existing thromboembolic condition.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAnesthesia procedure \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll procedures were performed with use of endoscopist-directed sedation. Patients were sedated with midazolam and pethidine with or without propofol. The target sedation level was mild to moderate [19]. For sedation induction, midazolam 3 mg and pethidine 25 mg were intravenously injected. Thereafter, additional propofol, midazolam, or pethidine was intravenously injected to ensure adequate sedation or pain control. Oxygen was supplied at a constant level of 2 L/min via a nasal prong during the procedure, and sedative medication doses were adjusted according to the vital signs of patients. We monitored blood pressure, heart rate, and oxygen saturation during the procedure.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOutcome Measures \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; The primary outcome was procedure- and sedation-related complications, while the secondary outcomes were procedure time and complete resection rate.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eProcedure-related complications\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eProcedure-related bleeding was defined as bleeding requiring transfusion or emergency endoscopy or that reduced the hemoglobin level by more than 2 g/dL following the procedure. We defined immediate bleeding as bleeding occurring within 24 hours after the endoscopic resection and delayed bleeding as gastrointestinal bleeding occurring later than 24 hours after the endoscopic resection [20, 21]. Procedure-related perforation was defined as endoscopically observed extraluminal space or intra-abdominal free air on chest radiography taken after the procedure [21].\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eSedation-related complications\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSedation-related complications were divided into immediate complications (hypotension, arrhythmia, hypoxia) during endoscopy and post-procedural complications (respiratory complications such as atelectasis and pneumonia).\u003c/p\u003e\n\u003cp\u003eHypotension during the procedure was defined as systolic blood pressure below 90 mmHg. Oxygen desaturation was defined as oxygen arterial saturation \u0026lt; 90% for at least 10 seconds. Supplemental oxygen was given to maintain oxygen arterial saturation \u0026gt; 90%. Bradycardia was defined as any episode of heart rate \u0026lt; 40 beats per minute.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; All patients underwent pre-procedure chest radiography at the time of admission. Atelectasis was diagnosed by comparison of post-procedure and pre-procedure chest radiographic findings, regardless of clinical symptoms. Radiographic findings of atelectasis include direct signs such as crowding of pulmonary vessels, crowed air bronchogram, and displacement of interlobar fissure as well as indirect signs such as pulmonary opacification and elevation of the ipsilateral diaphragm. Pneumonia was defined as newly developed pulmonary infiltration with clinical symptoms such as cough, sputum, and fever with chilling. In these cases, proper antibiotics were administered.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eProcedure time\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eProcedure time was defined as the time from the start of intravenous administration of the sedative agent to the time of endoscope extubation.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eComplete resection\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eComplete resection was defined as follows: 1) tumor removed in one piece (en bloc resection) and horizontal/vertical margin was histologically free from tumorous glands; or 2) tumor removed in multiple pieces (piecemeal resection) and follow-up endoscopy revealed no recurrence for at least 1 year.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eFollow up endoscopy\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFollow-up endoscopy was performed 3-6 months after endoscopic resection, and follow-up endoscopy was performed every year thereafter. We defined tumor recurrence as local recurred or metachronous lesions in the stomach after 1 year after endoscopic resection of the primary lesion.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analysis\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Statistical analysis was performed using SPSS version 23.0 (SPSS Inc., Chicago, IL, USA). Continuous data are shown as mean \u0026plusmn; standard deviation or median (range), while categorical data are shown as absolute and relative frequencies. Continuous variables were analyzed using Student\u0026rsquo;s t-test. Categorical data were examined using Fisher\u0026rsquo;s exact test or the chi-squared test. On multivariate analysis, binary logistic regression models with forward conditioning were used to investigate CCI-associated complications. The data included in the regression analysis are presented as crude or adjusted odds ratios with 95% confidence intervals (CIs). Variables with P values \u0026lt; 0.05 on the univariate analysis were selected for inclusion in the multivariate analysis.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e\u003cstrong\u003ePatient demographics\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; The mean patient age was 78.7 \u0026plusmn; 3.2 years. Of the 242 patients, 124 (51.2%) had low-grade dysplasia and 112 (46.3%) had carcinoma in situ or adenocarcinoma (Table 1). The most common comorbidity was hypertension (55.4%), followed by diabetes (23.1%) (Table 2). A total of 141 (58.3%) patients underwent ESD. Seventy-one (31%) patients underwent endoscopic resection of multiple lesions in a single session. The mean procedure time was 34.9 \u0026plusmn; 23.7 minutes, and the mean hospital stay was 5.0 \u0026plusmn; 1.7 days. Midazolam was used in all patients and propofol was used in 215 (88.8%) patients.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCharlson comorbidity index \u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/strong\u003eThe mean CCI score was 1.67 \u0026plusmn; 1.43 (range, 0-7). Figure 1 shows the distribution of the CCI score in the 242 patients: 59 (24.4%) had a CCI score of 0, 65 (26.9%) had a CCI score of 1, 58 (24.0%) had a CCI score of 2, 29 (12.0%) had a CCI score of 3, 23 (9.5%) had a CCI score of 4, 6 (2.5%) had a CCI score of 5, 1 (0.4%) had a CCI score of 6, and 1 (0.4%) had a CCI score of 7. Thus, 182 patients had a low CCI score (\u0026lt;3) and 60 had a high CCI score (\u0026ge;3).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eProcedure-related complications\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eProcedure-related complications included immediate bleeding (4.1%), delayed bleeding (0.8%) and perforation (1.2%). There were no significant differences in procedure-related complications between the low and high CCI groups.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSedation-related complications\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDuring the procedure, there were 10 (4.1%) patients with desaturation recovered by flumazenil with use mask (n = 2) or Ambu bag (n = 3) ventilation. No patient received endotracheal intubation during endoscopic procedure. There were no significant differences in the incidence of hypotension or hypoxia during the procedure between the low and high CCI groups.\u003c/p\u003e\n\u003cp\u003ePost-procedural complications such as atelectasis or pneumonia occurred in 45 (18.6%) patients. In 4 patients, pneumonia was diagnosed due to fever, respiratory symptoms, and chest radiography abnormalities. These patients were treated with antibiotics and improved without sequelae. Most other patients improved spontaneously during the outpatient follow-up period (Figure 2).\u003c/p\u003e\n\u003cp\u003eThe incidence of respiratory complications such as atelectasis or pneumonia tended to increase with CCI score: 20.3% (n = 12/59) in patients with a score of 0, 9.2% (n = 6/65) in patients with a score of 1, 12.1% (n = 7/58) in patients with a score of 2, 34.5% (n = 10/29) in patients with a score of 3, 39.1% (n = 9/23) in patients with a score of 4, and 12.5% (n = 1/8) in patients with a score of 5 or more (Figure 3). The incidence of atelectasis was 20/60 (33.3%) in patients with a CCI score \u0026ge;3 and 21/182 (11.5%) in patients with a CCI score \u0026lt; 3 (P\u0026lt;0.01). Post-procedural pneumonia developed only in 4 patients of CCI\u0026lt;3. The incidence of respiratory complications (atelectasis or pneumonia) was higher in the group with a CCI score \u0026ge; 3 (Table 3).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Uni- and multivariate analyses showed that age and presence of a CCI score \u0026ge; 3 were related to the incidence of atelectasis or pneumonia after endoscopic resection in extremely elderly patients. The adjusted odds ratio for patients with a CCI score \u0026ge; 3 and the development of atelectasis or pneumonia was 3.103 (95% CI, 1.538 \u0026ndash; 6.261, Table 4).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cem\u003eClinical outcomes\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; En bloc resection was achieved in 90.5% (219/242) of patients, while complete resection was achieved in 87.2% (211/242) of patients. Among 31 patients with incomplete resection, 12.9% (4/31) patients underwent additional operation and 3.2% (1/31) underwent additional endoscopic resection. There was no significant difference in the en bloc resection or complete resection rates between the patients with low and high CCI scores (Table 3). Tumor recurrence occurred in 3.8% (8/211) patients with complete resection. \u0026nbsp;.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eOur study demonstrated that: (1) endoscopic resection was effective and safe for extremely elderly (\u0026ge;75 years of age) patients with gastric neoplasms under careful consideration; and (2) age and higher CCI score (\u0026ge;3) were independent risk factors for atelectasis or pneumonia after endoscopic resection in extremely elderly patients.\u003c/p\u003e\n\u003cp\u003eSeveral studies have examined the treatment outcomes and safety of endoscopic resection in elderly patients, which showed no significant difference in treatment outcomes of endoscopic resection of early gastric cancer in elderly patients [4-6]. In our study including extremely elderly patients, the en bloc resection rate was 90.5% and the complete resection rate was 87.2%, similar to the rates reported in previous studies [4, 7, 20, 21]. Procedure-related bleeding and procedure-related perforation was observed in 4.9% and 0.4% of extreme elderly patients, respectively. These complication rates were comparable in those of other studies including elderly or non-elderly patients [7, 20]. Sedation-related complications such as intra-procedural hypotension and oxygen desaturation is known to be occurred more frequently in elderly patients[20, 22]. Furthermore, post-procedural respiratory complications such as atelectasis or pneumonia developed more frequently in elderly patients than in nonelderly patients [7, 20]. Tokioka et al. demonstrated that recovery time from respiratory complications was longer and performance score was higher after endoscopic resection of early gastric cancer in patients aged 65 years and older [4]. In our study, significant hypoxemia occurred in 4.1% and post-procedural respiratory complications occurred in 18.6% (atelectasis in 16.9% and pneumonia in 1.7%). Development of atelectasis in perioperative patients is associated with decreased lung compliance and increased pulmonary vascular resistance leading to lung injury and impairment of oxygenation [23]. Even though most patients with atelectasis recovered with conservative treatment in this study, persistent prolonged atelectasis after anesthesia is known to increase perioperative respiratory complications leading to significant consequence, especially in patients with underlying lung disease or cardiopulmonary dysfunction [23-26]. Therefore, early detection of atelectasis and effort for reversal of atelectasis in those patients may prevent significant periprocedural respiratory complication and improve clinical outcomes.\u003c/p\u003e\n\u003cp\u003eIn recent studies, respiratory complication after endoscopic resection was found to be significantly related to the procedure time, the degree of sedation, and the amount of propofol use [27, 28]. In our study, respiratory complication tended to increase with increasing procedure time, but it was not statistically significant. In addition, there was no correlation between the use of propofol or the dose used, and an increase in respiratory complication.\u003c/p\u003e\n\u003cp\u003eCharlson et al developed a scoring system to classify prognostic comorbidity and predict in-hospital and 1-year mortality rates [13]. Several studies reported that CCI predicted the prognosis of various diseases such as ischemic stroke [14], end-stage renal disease [15], cirrhosis [17], and lung cancer [29]. It could be adapted to patients in health care [30] and post-operative outcomes in acute cholecystitis [31]. In our study, CCI score was not related to procedure-related complications or immediate sedation-related complications such as hypoxemia or hypotension. However, post-procedural complications including atelectasis/pneumonia were frequently observed in extremely elderly patients with higher a CCI score (\u0026ge;3). Therefore, we expect to apply CCI score to other advanced endoscopic procedures including endoscopic retrograde cholangio-pancreatography, endoscopic ultrasonography-guided intervention, submucosal tunneling endoscopic resection or enteroscopy in elderly patients to evaluate the risk for periprocedural complications.\u003c/p\u003e\n\u003cp\u003eThis study has several limitations; first, this study might not have included patients with very severe or uncontrolled comorbidities due to its retrospective design. All enrolled patients could be selected since they were considered suitable candidates for endoscopic therapy by the endoscopist. However, it is not possible to design a prospective study that enrolls only patients with severe morbidities due to ethical concerns. Second, we could not get the information for effect of sedative agents, as clinician choose the sedative agents for the procedure according to risk assessment of procedural complication.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eIn conclusion, although endoscopic resection is considered safe and effective for elderly patients, endoscopists must perform it cautiously, particularly in extremely elderly patients with a high CCI score, to prevent post-procedural respiratory complications such as pneumonia or atelectasis. In the future, we need to conduct a study to prevent postprocedural respiratory complication\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eCCI\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; Charlson comorbidity index\u003c/p\u003e\n\u003cp\u003eEMR\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; endoscopic mucosal resection\u003c/p\u003e\n\u003cp\u003eESD\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; endoscopic submucosal dissection\u003c/p\u003e"},{"header":"Declarations","content":"\u003cul\u003e\n\u003cli\u003e\u003cstrong\u003eEthics approval and consent to participate: \u003c/strong\u003eEthics Committee of the Chonnam National University Hospital approved this current study. CNUH-2018-236).\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e: Not Applicable\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eAvailability of data and material\u003c/strong\u003e: The datasets used and/or analyzed during the current study available from the corresponding author on request.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e: The authors have no conflicts of interests\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e This study was supported by the Chonnam National University Hospital Research Institute of Clinical Medicine (CRI 14011-1 and B2019-1047). This funding source had no role in the design of this study and collection, analysis and interpretation of data and in writing the manuscript.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eAuthors' contributions:\u003c/strong\u003e All authors have read and approved this manuscript.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eSK analyzed electronic medical records and drafted a manuscript. DHK developed the concept of study, analyzed of electronic medical records, and wrote manuscript. SK and DHK contributed equally as co-first authors. SYP made substantial contributions to the conception and design of the study, interpreted data, wrote the paper and revised it critically for intellectual contents. CHP, HSK, SKC and JSR performed the literature review and collected clinical data. All authors (SK, DHK, SYP, CHP, HSK, SKC and JSR) have read and approved the final manuscript.\u003c/p\u003e\n\u003cul\u003e\n\u003cli\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e: No\u003c/li\u003e\n\u003c/ul\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eOka S, Tanaka S, Kaneko I, Mouri R, Hirata M, Kawamura T, Yoshihara M, Chayama K: \u003cstrong\u003eAdvantage of endoscopic submucosal dissection compared with EMR for early gastric cancer\u003c/strong\u003e. \u003cem\u003eGastrointest Endosc \u003c/em\u003e2006, \u003cstrong\u003e64\u003c/strong\u003e(6):877-883.\u003c/li\u003e\n\u003cli\u003eTakeuchi Y, Uedo N, Iishi H, Yamamoto S, Yamamoto S, Yamada T, Higashino K, Ishihara R, Tatsuta M, Ishiguro S: \u003cstrong\u003eEndoscopic submucosal dissection with insulated-tip knife for large mucosal early gastric cancer: a feasibility study (with videos)\u003c/strong\u003e. \u003cem\u003eGastrointest Endosc \u003c/em\u003e2007, \u003cstrong\u003e66\u003c/strong\u003e(1):186-193.\u003c/li\u003e\n\u003cli\u003eOda I, Gotoda T, Hamanaka H, Eguchi T, Saito Y, Matsuda T, Bhandari P, Emura F, Saito D, Ono H: \u003cstrong\u003eEndoscopic submucosal dissection for early gastric cancer: technical feasibility, operation time and complications from a large consecutive series\u003c/strong\u003e. \u003cem\u003eDigestive endoscopy \u003c/em\u003e2005, \u003cstrong\u003e17\u003c/strong\u003e(1):54-58.\u003c/li\u003e\n\u003cli\u003eTokioka S, Umegaki E, Murano M, Takeuchi N, Takeuchi T, Kawakami K, Yoda Y, Kojima Y, Higuchi K: \u003cstrong\u003eUtility and problems of endoscopic submucosal dissection for early gastric cancer in elderly patients\u003c/strong\u003e. \u003cem\u003eJ Gastroenterol Hepatol \u003c/em\u003e2012, \u003cstrong\u003e27 Suppl 3\u003c/strong\u003e:63-69.\u003c/li\u003e\n\u003cli\u003eKakushima N, Fujishiro M, Kodashima S, Muraki Y, Tateishi A, Yahagi N, Omata M: \u003cstrong\u003eTechnical feasibility of endoscopic submucosal dissection for gastric neoplasms in the elderly Japanese population\u003c/strong\u003e. \u003cem\u003eJ Gastroenterol Hepatol \u003c/em\u003e2007, \u003cstrong\u003e22\u003c/strong\u003e(3):311-314.\u003c/li\u003e\n\u003cli\u003eHirasaki S, Tanimizu M, Nasu J, Shinji T, Koide N: \u003cstrong\u003eTreatment of elderly patients with early gastric cancer by endoscopic submucosal dissection using an insulated-tip diathermic knife\u003c/strong\u003e. \u003cem\u003eIntern Med \u003c/em\u003e2005, \u003cstrong\u003e44\u003c/strong\u003e(10):1033-1038.\u003c/li\u003e\n\u003cli\u003eIsomoto H, Ohnita K, Yamaguchi N, Fukuda E, Ikeda K, Nishiyama H, Akiyama M, Ozawa E, Nakao K, Kohno S\u003cem\u003e et al\u003c/em\u003e: \u003cstrong\u003eClinical outcomes of endoscopic submucosal dissection in elderly patients with early gastric cancer\u003c/strong\u003e. \u003cem\u003eEur J Gastroenterol Hepatol \u003c/em\u003e2010, \u003cstrong\u003e22\u003c/strong\u003e(3):311-317.\u003c/li\u003e\n\u003cli\u003eZhang Y, Huang L, Li L, Ji F: \u003cstrong\u003eEndoscopic submucosal dissection for early gastric neoplasms in elderly patients\u003c/strong\u003e. \u003cem\u003eJ Laparoendosc Adv Surg Tech A \u003c/em\u003e2014, \u003cstrong\u003e24\u003c/strong\u003e(6):391-398.\u003c/li\u003e\n\u003cli\u003e\u003cstrong\u003eFrom the Centers for Disease Control and Prevention. 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text-indent: -.5in; line-height: 115%;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12pt; line-height: 115%; font-family: 'Times New Roman', serif;\"\u003eTable 1. Endoscopic and histologic findings in 242 elderly patients\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003ctable style=\"border-collapse: collapse; border: none;\"\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 262.0pt; border: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"349\"\u003e\n\u003cp style=\"line-height: 115%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 115%; font-family: 'Times New Roman',serif;\"\u003eVariables\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 177.2pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"236\"\u003e\n\u003cp style=\"text-align: center; line-height: 115%;\"\u003e\u003cspan style=\"font-size: 12.0pt; line-height: 115%; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 262.0pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"349\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003eNumber of lesions, n (%)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 177.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"236\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 262.0pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"349\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp; Single\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 177.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"236\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e166 (68.6)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 262.0pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"349\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp; Multiple\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 177.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"236\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e76 (31.4)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 262.0pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"349\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003eLocation of lesion, n (%)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 177.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"236\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 262.0pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"349\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp; Upper 1/3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 177.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"236\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e28 (11.5)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 262.0pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"349\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp; Mid 1/3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 177.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"236\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e78 (32.2)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 262.0pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"349\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp; Lower 1/3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 177.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"236\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e136 (56.2)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 262.0pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"349\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003eMacroscopic appearance, n (%)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 177.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"236\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 262.0pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"349\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp; Flat/depressed\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 177.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"236\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e67 (27.7)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 262.0pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"349\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp; Elevated\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 177.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"236\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e175 (72.3)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 262.0pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"349\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003eHistologic findings, n (%)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 177.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"236\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 262.0pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"349\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp; Low-grade dysplasia\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 177.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"236\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e124 (51.2)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 262.0pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"349\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp; Carcinoma in situ or adenocarcinoma\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 177.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"236\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e112 (46.3)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 262.0pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"349\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp; Other\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 177.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"236\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e6 (2.5)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 262.0pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"349\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003eMethod of endoscopic resection, n (%)\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 177.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"236\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 262.0pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"349\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp; EMR\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 177.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"236\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e100 (41.3)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 262.0pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"349\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp; ESD\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 177.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"236\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e142 (58.7)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 13.4pt;\"\u003e\n\u003ctd style=\"width: 262.0pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 13.4pt;\" width=\"349\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003eMean procedure time, min, mean \u0026plusmn; SD\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 177.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 13.4pt;\" width=\"236\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e34.9 \u0026plusmn; 23.7 \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 13.4pt;\"\u003e\n\u003ctd style=\"width: 262.0pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 13.4pt;\" width=\"349\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003eMethod of Sedation \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 177.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 13.4pt;\" width=\"236\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 13.4pt;\"\u003e\n\u003ctd style=\"width: 262.0pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 13.4pt;\" width=\"349\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp; Midazolam + Propofol+ Pethidine\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 177.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 13.4pt;\" width=\"236\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e215 (88.8)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 13.4pt;\"\u003e\n\u003ctd style=\"width: 262.0pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 13.4pt;\" width=\"349\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp; Midazolam + Pethidine\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 177.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 13.4pt;\" width=\"236\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e27 (11.2)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 13.4pt;\"\u003e\n\u003ctd style=\"width: 262.0pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt; height: 13.4pt;\" width=\"349\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003eDose of sedative agents, mean \u0026plusmn; SD\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 177.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt; height: 13.4pt;\" width=\"236\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 262.0pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"349\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp; Midazolam, mg\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 177.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"236\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e3.43 \u003c/span\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e\u0026plusmn;\u003c/span\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e 1.16\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 262.0pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"349\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp; Propofol, mg\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 177.2pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"236\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e112.0 \u003c/span\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e\u0026plusmn; \u003c/span\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e88.0\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp style=\"margin-right: 14.8pt; text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003eEMR, endoscopic mucosal resection; ESD, endoscopic submucosal dissection; SD, standard deviation\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003eTable 2. Baseline characteristics and comorbidities of elderly patients who underwent endoscopic resection\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003ctable style=\"border-collapse: collapse; border: none;\"\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003eVariables\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003eAge, yrs, mean \u0026plusmn; SD\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e78.7 \u0026plusmn; 3.2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003eFemale sex, n (%)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e101 (41.7)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003eBody mass index, kg/m\u003csup\u003e2\u003c/sup\u003e, mean \u0026plusmn; SD\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e23.7 \u0026plusmn; 3.3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003eComorbidities, variable CCI, n (%)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003eWeighting\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp; Acute myocardial infarction\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e30 (12.4)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp; Congestive heart failure\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e11 (4.5)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp; Peripheral vascular disease\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e3 (1.2)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp; Cerebrovascular accident \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e11 (4.5)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp; Dementia\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e5 (2.1)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp; Chronic pulmonary disease \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e27 (11.2)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp; Connective tissue disease\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e0 (0)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp; Ulcer disease\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e0 (0)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp; Mild liver disease \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e13 (5.4)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp; Hepatitis\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e8 (3.3)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp; Diabetes \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e56 (23.1)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp; Diabetes with end organ damage\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e0 (0)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp; Hemiplegia\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e0 (0)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp; Moderate or severe renal disease \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e3 (1.2)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp; Any tumor\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e31 (12.8)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp style=\"tab-stops: right 171.8pt;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp; Leukemia\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e0 (0)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp; Lymphoma\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e0 (0)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp; Moderate to severe liver disease\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e5 (2.1)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp; Metastatic solid tumor\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e6\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e0 (0)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp; Acquired immunodeficiency syndrome\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e6\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e0 (0)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003eCharlson comorbidity index, mean \u0026plusmn; SD\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e1.67 \u0026plusmn; 1.43\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003eASA-PS, mean \u0026plusmn; SD\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e2.01 \u0026plusmn; 0.49\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003eECOG-PS, mean \u0026plusmn; SD\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e1.55 \u0026plusmn; 0.55\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003eMedication, n (%) \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp; Aspirin\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e70 (28.9)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp; Clopidogrel \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e10 (4.1)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 210.95pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"281\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp; Antithrombotic agents\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 63.8pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 148.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"198\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif;\"\u003e1 (0.4)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12.0pt; font-family: 'Times New Roman',serif;\"\u003eSD, standard deviation; ASA-PS, American Society of Anesthesiologists Performance Status; \u003cspan style=\"background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003eCCI, Charlson comorbidity index\u003c/span\u003e, ECOG-PS, Eastern Cooperative Oncology Group Performance Status\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003eTable 3. Treatment outcomes and complications by CCI score\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003ctable style=\"width: 447.15pt; border-collapse: collapse; border: none;\" width=\"596\"\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 181.75pt; border: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"242\"\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003eCCI \u0026lt; 3 (n =182)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003eCCI \u0026ge; 3 (n =60)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.35in; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"130\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 11pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003eP value\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 181.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"242\"\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003eAge, mean \u0026plusmn; SD\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e78.6 \u0026plusmn; 3.1\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e79.0 \u0026plusmn; 3.3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.35in; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"130\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0.38\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 181.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"242\"\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003eSex (female)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e81 (44.5)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e20 (33.3)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.35in; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"130\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0.13\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 181.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"242\"\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003eProcedure time, min, median (range) \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e30 (4 ~150)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e25 (5 ~120)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.35in; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"130\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0.05\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 181.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"242\"\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003eResectability, n (%)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.35in; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"130\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 181.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"242\"\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp; En bloc resection\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e161 (88.5)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e58 (96.7)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.35in; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"130\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0.06\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 181.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"242\"\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp; Piecemeal resection\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e21 (11.5)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e2 (3.3)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.35in; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"130\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 181.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"242\"\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003eMethod of sedation, n (%)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.35in; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"130\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 181.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"242\"\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u0026nbsp;Midazolam + Pethidine + Propofol\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e160 (87.9)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e55 (91.7)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.35in; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"130\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0.42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 181.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"242\"\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u0026nbsp;Midazolam + Pethidine\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e22 (12.1)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e5 (8.3)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.35in; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"130\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 181.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"242\"\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003eDose of sedative agents, mean \u0026plusmn; SD\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.35in; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"130\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 181.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"242\"\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp; Midazolam, mg\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e3.65 \u003c/span\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026plusmn; 0.95\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e3.39 \u003c/span\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026plusmn; 0.87\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.35in; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"130\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0.07\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 181.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"242\"\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp; Propofol, mg\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e126.4 \u003c/span\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026plusmn; 79.2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e132.6 \u003c/span\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026plusmn; 92.5\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.35in; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"130\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0.64\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 181.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"242\"\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003eProcedure-related complications, n (%)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.35in; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"130\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 181.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"242\"\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp; Immediate bleeding\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e10 (5.5)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.35in; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"130\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0.06\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 181.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"242\"\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp; Delayed bleeding\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e2 (1.1)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.35in; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"130\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0.42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 181.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"242\"\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u0026nbsp;\u0026nbsp; Perforation\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e3 (1.6)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.35in; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"130\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0.32\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 181.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"242\"\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003eSedation-related complications, n (%)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.35in; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"130\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 181.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"242\"\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp; Immediate complication\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.35in; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"130\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 181.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"242\"\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u0026nbsp; Hypotension\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e1 (0.5)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.35in; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"130\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0.57\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 181.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"242\"\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u0026nbsp; Arrhythmia\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e37 (20.3)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e14 (23.3)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.35in; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"130\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0.62\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 181.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"242\"\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u0026nbsp; Hypoxia\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e8 (4.4)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e2 (3.3)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.35in; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"130\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0.72\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 181.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"242\"\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u0026nbsp; Hypopnea or apnea\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e1 (0.5)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.35in; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"130\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0.57\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 181.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"242\"\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp; Delayed complication\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.35in; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"130\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 181.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"242\"\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u0026nbsp; Atelectasis\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e21 (11.5)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e20 (33.3)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.35in; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"130\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026lt;0.01\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 181.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"242\"\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u0026nbsp; Pneumonia\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e4 (2.2)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0 (0)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.35in; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"130\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0.25\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 181.75pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"242\"\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u0026nbsp; Atelectasis or Pneumonia\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e25 (13.7)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 84.1pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"112\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e20 (33.3)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 1.35in; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"130\"\u003e\n\u003cp style=\"text-align: center; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026lt;0.01\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003eCCI, Charlson comorbidity index\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp style=\"text-align: left; text-autospace: ideograph-numeric ideograph-other; word-break: normal;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003eTable 4. Univariate and multivariate analysis for predicting atelectasis/pneumonia after endoscopic resection in elderly patients\u003c/span\u003e\u003c/strong\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"width: 462.9pt; border-collapse: collapse; border: none;\" width=\"617\"\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 131.4pt; border: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"175\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003eVariables\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.85pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"158\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003ecOR (95% CI)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 49.65pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"66\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003eP value\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 113.4pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"151\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003eaOR (95% CI)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 49.6pt; border: solid windowtext 1.0pt; border-left: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"66\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003eP value\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 131.4pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"175\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003eAge, yrs\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"158\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e1.175 (1.065 \u0026ndash; 1.296)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 49.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"66\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0.001\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 113.4pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"151\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e1.173 (1.061 \u0026ndash; 1.297)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 49.6pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"66\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0.002\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 131.4pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"175\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003eSex (female)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"158\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0.781 (0.408 \u0026ndash; 1.498)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 49.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"66\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0.458\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 113.4pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"151\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 49.6pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"66\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 131.4pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"175\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003eBody mass index, kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"158\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0.999 (0.904 \u0026ndash; 1.105)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 49.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"66\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0.987\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 113.4pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"151\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 49.6pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"66\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 131.4pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"175\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003eCCI \u0026ge; 3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"158\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e3.140 (1.586 \u0026ndash; 6.215)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 49.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"66\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0.001\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 113.4pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"151\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e3.103 (1.538 \u0026ndash; 6.261)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 49.6pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"66\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0.002\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 131.4pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"175\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003eUse of propofol\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"158\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0.738 (0.242 \u0026ndash; 2.251)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 49.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"66\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0.593\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 113.4pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"151\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 49.6pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"66\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 131.4pt; border: solid windowtext 1.0pt; border-top: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"175\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003eProcedure time, min\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.85pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"158\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e1.012 (1.000 \u0026ndash; 1.025)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 49.65pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"66\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e0.056\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 113.4pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"151\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 49.6pt; border-top: none; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"66\"\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003ecOR, \u003c/span\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; background-position: 0% 0%; background-repeat: repeat; background-attachment: scroll; background-image: none; background-size: auto; background-origin: padding-box; background-clip: border-box;\"\u003ecrude odds ratio; aOR, adjusted OR; CCI, Charlson comorbidity index\u003c/span\u003e\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-gastroenterology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmge","sideBox":"Learn more about [BMC Gastroenterology](http://bmcgastroenterol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bmge/default.aspx","title":"BMC Gastroenterology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Endoscopic mucosal resection, Aged, Comorbidity, Stomach neoplasms","lastPublishedDoi":"10.21203/rs.2.16786/v2","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.2.16786/v2","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eBackground: Although endoscopic resection is safe and effective for gastric epithelial neoplasms, information is limited on its efficacy and safety in extremely elderly patients who have various comorbidities. Further, the relationship between comorbidities and complications of endoscopic resection is not well established. Therefore, we aimed to evaluate the efficacy and safety of endoscopic resection of gastric epithelial neoplasms in extremely elderly patients. \u003c/p\u003e\u003cp\u003eMethods: From October 2008 to December 2017, 4475 consecutive patients underwent endoscopic resection of gastric epithelial neoplasms. Among them, 242 were 75 years or older. We assessed Charlson comorbidity index (CCI) scores, procedural outcomes, and procedure- and sedation-related complications related to endoscopic resection. \u003c/p\u003e\u003cp\u003eResults: Mean patient age was 78.7 ± 3.2 years. Of the 242 patients, 124 (51.2%) had low-grade dysplasia and 112 (46.3%) had adenocarcinoma. The most common comorbidity was hypertension (55.4%), followed by diabetes (23.1%). The mean CCI score was 1.67 ± 1.43. Sixty patients (24.8%) had a CCI score ≥ 3. During the procedure, 10 (4.1%) patients had desaturation that recovered by flumazenil use with mask (n=2) or Ambu bag (n=3) ventilation. During subsequent admission, atelectasis or pneumonia occurred in 45 (18.6%) patients, post-procedural bleeding in 12 (5.0%), and perforation in 3 (1.2%). Respiratory complications were more common in patients with a CCI score ≥ 3 (20/60, 33.3%) than in those with a CCI score \u0026lt; 3 (25/182, 13.7%, P=0.002). \u003c/p\u003e\u003cp\u003eConclusions: CCI score is related to respiratory complications of endoscopic resection in extremely elderly patients. Endoscopic resection must be performed cautiously, particularly in elderly patients with a high CCI score, to prevent respiratory complications.\u003c/p\u003e","manuscriptTitle":"Association Between Charlson Comorbidity Index and Complications of Endoscopic Resection of Gastric Neoplasms in Elderly Patients","msid":"","msnumber":"","nonDraftVersions":[{"code":2,"date":"2020-05-29 02:06:06","doi":"10.21203/rs.2.16786/v2","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Minor revision","date":"2020-06-23T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2020-06-17T12:00:00+00:00","index":1,"fulltext":"Recommendation: Accept without revision\nForm responses:\n---\n\nComments to Author:\n---\nThank you for your response.\n\nThe manuscript was well revised according to reviewer's comments.* Are the methods appropriate and well described?: **Yes**\n* Does the work include the necessary controls?: **Yes**\n* Are the conclusions drawn adequately supported by the data shown?: **Yes**\n* Are you able to assess any statistics in the manuscript or would you recommend an additional statistical review?: **I am able to assess the statistics**\n* Quality of written English: **Needs some language corrections before being published**\n* Declaration of competing interests: **I declare that I have no competing interests.**\n* Reviewer Publication Consent. I agree for my report to be made available under an Open Access Creative Commons CC-BY License (http://creativecommons.org/licenses/by/4.0) if this manuscript is accepted for publication. Any comments that I do not wish to be included in the published report have been included as confidential comments to the editor, which will not be published.: **I agree to the terms of the CC-BY 4.0 license; please do not publish my name with my report. (default)**\n* Publons Reviewer Recognition. Springer Nature can send verification of this review directly to Publons (a subsidiary of Clarivate Analytics). If you would like to take advantage of this service, please click on the “Yes” option below. Your name, email address, title of the reviewed manuscript, name of the journal, and date of your review submission (the “Review Data”) will then be transmitted to Publons upon publication of the manuscript. If you have already registered at Publons, they will notify you of the receipt of this review and update your profile as per your settings and their policy. If you are not registered with Publons, you will receive an email from them asking you to register in order for them to be able to recognize your review on your new profile page. Publons may use the Review Data to generate derivative metadata for the benefit of Publons and you as a reviewer, carefully considering the sensitivity of such information. For example, Publons may verify your record as a reviewer by updating your profile published on its webservice if you have registered for such service or help editors to identify candidate reviewers. Please find the details of processing in Publons’ privacy policy https://publons.com/about/terms: **No**\n"},{"type":"reviewerAgreed","content":"","date":"2020-05-29T12:00:00+00:00","index":2,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2020-05-29T12:00:00+00:00","index":2,"fulltext":"Recommendation: Accept without revision\nForm responses:\n---\n\nComments to Author:\n---\nIt has been revised according to reviewers' comments.* Are the methods appropriate and well described?: **Yes**\n* Does the work include the necessary controls?: **Yes**\n* Are the conclusions drawn adequately supported by the data shown?: **Yes**\n* Are you able to assess any statistics in the manuscript or would you recommend an additional statistical review?: **I am able to assess the statistics**\n* Quality of written English: **Not suitable for publication unless extensively edited**\n* Declaration of competing interests: **I declare that I have no competing interests.**\n* Reviewer Publication Consent. I agree for my report to be made available under an Open Access Creative Commons CC-BY License (http://creativecommons.org/licenses/by/4.0) if this manuscript is accepted for publication. Any comments that I do not wish to be included in the published report have been included as confidential comments to the editor, which will not be published.: **I agree to the terms of the CC-BY 4.0 license; please do not publish my name with my report. (default)**\n"},{"type":"reviewersInvited","content":"","date":"2020-05-28T12:00:00+00:00","index":"","fulltext":""},{"type":"reviewerAgreed","content":"","date":"2020-05-28T12:00:00+00:00","index":1,"fulltext":""},{"type":"editorAssigned","content":"","date":"2020-05-19T12:00:00+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2020-05-18T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2020-05-18T12:00:00+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-gastroenterology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmge","sideBox":"Learn more about [BMC Gastroenterology](http://bmcgastroenterol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bmge/default.aspx","title":"BMC Gastroenterology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}},{"code":1,"date":"2019-11-05 18:40:34","doi":"10.21203/rs.2.16786/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Major revision","date":"2020-04-30T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2020-04-27T12:00:00+00:00","index":2,"fulltext":"Recommendation: Major revisions required\nForm responses:\n---\n\nComments to Author:\n---\n1) Were all sedation performed by anethesiologists or gastroenterologists?\n2) Was there any patient receive endotracheal intubation during endoscopic surgery?\n3) How was the antiplatelet agents discontinued and resumed for endoscopic procedure?\n4) Please define the time-period for \"post-procedural\" complications\n5) Was there any difference between elderly patients with low and high CCI scores after endoscopic resection in terms of mid- or long-term survival, and tumor recurrence ?\n6) Please expand the contents of discussion parts, such as the application of CCI score for other clinical settings, other scoring or prognostic system for elderly patients after advanced endoscopic procedures…?\n* Are the methods appropriate and well described?: **Yes**\n* Does the work include the necessary controls?: **Yes**\n* Are the conclusions drawn adequately supported by the data shown?: **Yes**\n* Are you able to assess any statistics in the manuscript or would you recommend an additional statistical review?: **I am able to assess the statistics**\n* Quality of written English: **Needs some language corrections before being published**\n* Declaration of competing interests: **I declare that I have no competing interests.**\n* I agree to the open peer review policy of the journal. I understand that my name will be included on my report to the authors and, if the manuscript is accepted for publication, my named report including any attachments I upload will be posted on the website along with the authors' responses. I agree for my report to be made available under an Open Access Creative Commons CC-BY license (http://creativecommons.org/licenses/by/4.0/). I understand that any comments which I do not wish to be included in my named report can be included as confidential comments to the editors, which will not be published.: ** I agree to the open peer review policy of the journal**\n"},{"type":"reviewerAgreed","content":"","date":"2020-04-26T12:00:00+00:00","index":2,"fulltext":""},{"type":"editorInvitedReview","content":"","date":"2020-01-03T12:00:00+00:00","index":1,"fulltext":"Recommendation: Major revisions required\nForm responses:\n---\n\nComments to Author:\n---\nIn the present study, the authors reported that CCI score was related to respiratory complications of endoscopic resection in elderly patients and suggested that endoscopic resection should be performed cautiously in elderly patients with a high CCI score to prevent respiratory complications.\n\nThis study is interesting but there are points to this study which require clarifications or modifications.\n\nThe primary outcome in this study was procedure- and sedation-related complications. Pneumonia and atelectasis were considered respiratory complications in this study.\nIn the result, post-procedural complications such as atelectasis and pneumonia occurred in 45 (18.6%) patients. However, there were only 4 patients who had clinical symptoms and were treated with antibiotics. Most other patients had no symptom and improved spontaneously during the outpatient follow-up period.\nThus, it would be better to exclude the patients with radiologic atelectasis without symptoms or need for treatment and just include the patient with pneumonia or atelectasis with symptoms for the respiratory complication.\n\nThe authors used CCI combined with age in this study. However, age variable was also added on multivariate analysis and both \"age\" and \"CCI ≥ 6\" were associated with respiratory complications on multivariate analysis. Thus, CCI (combined with age) and age variable in this study might not be independent variables on linear regression analysis. have interaction. Thus, it should be better use original CCI (without age) for the better analysis.\n\n[Abstract: Results]\nPlease check the correct value of \"mean patient age\"\n(Abstract \u0026 Result: patient demographics) Mean patient age was 78 (range, 75-88) years.\n(Table 2) Age, yrs, mean ± SD: 78.7 ± 3.2\n\n[Methods: Assessment of CCI scores before endoscopic procedure].\n\"Cerebrovascular accident\" should be added in the component of CCI.\n\n[Results: Patient demographics \u0026 Table 1]\nPlease check the numbers of variables below (Table 1).\n-Number of lesions: 166+75 = 241 (≠242)\n-Macroscopic appearance: 77+175 = 252 (≠242)\n-Histologic findings: please check the variables in this part. \"High-grade dysplasia\" might be deleted.\n\nHow many patients were sedated with propofol? Please add the number of patients sedated with propofol.\n[Discussion]\nPlease reorganize the \"Discussion section\" according to the principles below.\n- This section should discuss the implications of the findings in context of existing research and highlight limitations of the study.\n- State the shortcommings and limitations of the study.\n\n[Figure 3]\nThere was no citation for figure 3 in the manuscript.\n* Are the methods appropriate and well described?: **Unable to assess**\n* Does the work include the necessary controls?: **Yes**\n* Are the conclusions drawn adequately supported by the data shown?: **Unable to assess**\n* Are you able to assess any statistics in the manuscript or would you recommend an additional statistical review?: **I am able to assess the statistics**\n* Quality of written English: **Needs some language corrections before being published**\n* Declaration of competing interests: **I declare that I have no competing interests.**\n* I agree to the open peer review policy of the journal. I understand that my name will be included on my report to the authors and, if the manuscript is accepted for publication, my named report including any attachments I upload will be posted on the website along with the authors' responses. I agree for my report to be made available under an Open Access Creative Commons CC-BY license (http://creativecommons.org/licenses/by/4.0/). I understand that any comments which I do not wish to be included in my named report can be included as confidential comments to the editors, which will not be published.: ** I agree to the open peer review policy of the journal**\n"},{"type":"reviewerAgreed","content":"","date":"2019-12-20T12:00:00+00:00","index":1,"fulltext":""},{"type":"reviewersInvited","content":"","date":"2019-12-05T12:00:00+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2019-10-29T12:00:00+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2019-10-25T12:00:00+00:00","index":"","fulltext":""},{"type":"submitted","content":"","date":"2019-10-24T12:00:00+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2019-10-24T12:00:00+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-gastroenterology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"bmge","sideBox":"Learn more about [BMC Gastroenterology](http://bmcgastroenterol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/bmge/default.aspx","title":"BMC Gastroenterology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"be1591be-0f04-40ac-b356-a8723aac42a6","owner":[],"postedDate":"May 29th, 2020","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":34856,"name":"Gastroenterology \u0026 Hepatology"}],"tags":[],"updatedAt":"2020-07-12T15:01:22+00:00","versionOfRecord":{"articleIdentity":"rs-7424","link":"https://doi.org/10.1186/s12876-020-01360-6","journal":{"identity":"bmc-gastroenterology","isVorOnly":false,"title":"BMC Gastroenterology"},"publishedOn":"2020-07-09 12:00:00","publishedOnDateReadable":"July 9th, 2020"},"versionCreatedAt":"2020-05-29 02:06:06","video":"","vorDoi":"10.1186/s12876-020-01360-6","vorDoiUrl":"https://doi.org/10.1186/s12876-020-01360-6","workflowStages":[]},"version":"v2","identity":"rs-7424","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"identity":"rs-7424","version":["v2"]},"buildId":"7rjqhiLT3MXkJMwkYKINL","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}