Recurrence of @entity253 following non-operative management in elderly XXXX .

@entity1 @entity788 @entity5990 @entity2679 @entity9485 @entity253 @entity255 @entity2877
INTRODUCTION: The purpose of this study was to determine the proportion of symptomatic recurrence following initial non-operative management of @entity5990 in the elderly and to test possible predictors. METHODS: This is a single institution retrospective chart review of @entity1  65 years and older with an initial hospital visit (V1) for symptomatic @entity5990 , over a 4-year period. @entity1 with initial "non-operative" management were defined as those without surgery @entity9485 and without elective surgery at visit 2 (V2). Baseline characteristics included age, sex, Charlson comorbidity index (CCI), diagnosis, and interventions (ERCP or cholecystostomy) @entity9485 . Outcomes assessed over 1  year were as follows: recurrence (any ER/admission visit following V1), surgery, complications, and mortality. A survival analysis using a Cox proportional hazards model was performed to assess predictors of recurrence. RESULTS: There were 195 @entity1 initially treated non-operatively @entity9485 . Mean age was 78.3      7.8  years, 45.6  % were male, and the mean CCI was 2.1      1.9. @entity9485 , 54.4  % had a diagnosis of @entity253 or @entity2679 , while 45.6  % had a diagnosis of @entity255 , @entity788 , or @entity2877 . 39.5  % underwent ERCP or cholecystostomy. Excluding 10 @entity1 who died @entity9485 , 31.3  % of @entity1 had a recurrence over the study period. Among these, 43.5  % had emergency surgery, 34.8  % had complications, and 4.3  % died. Median time to first recurrence was 2  months (range 6  days-4.8  months). Intervention @entity9485 was associated with a lower probability of recurrence (HR 0.3, CI [0.14-0.65]). CONCLUSION: One-third of elderly @entity1 will develop a recurrence following non-operative management of symptomatic @entity253 . These recurrences are associated with significant rates of emergency surgery and morbidity. Percutaneous or endoscopic therapies may decrease the risk of recurrence.
