Citation: Clinical Gastroenterology & Hepatology. 2020 Dec 10.Journal: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.Published: ; 2020ISSN: 1542-3565.Full author list: Chhoda A; Yousaf MN; Madhani K; Aslanian H; Jamidar PA; Suarez AL; Salem RA; Muniraj T; Kunstman J; Farrell JJ.UI/PMID: 33309984.Subject(s): IN PROCESS -- NOT YET INDEXEDInstitution(s): MedStar Union Memorial HospitalActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access onlineDigital Object Identifier: https://dx.doi.org/10.1016/j.cgh.2020.12.008 (Click here)Abbreviated citation: Clin Gastroenterol Hepatol. 2020 Dec 10.Abstract: BACKGROUND & AIMS: The Charlson Comorbidity Index (CACI) has been suggested as a tool to determine comorbidity burden and guide management for patients with mucinous pancreatic cysts (Intrapapillary Mucinous Neoplasms and Mucinous Cystic Neoplasms), but has not been studied well among "low-risk" mucinous pancreatic cysts i.e. without worrisome features (WF) and high-risk stigmata (HRS). This study sought to determine the comorbidity burden among surveillance population of low-risk pancreatic cysts and provide their follow-up mortality outcomes.Abstract: METHODS: A single center study retrospectively reviewed a prospective pancreatic cyst database and included individuals with low-risk cysts undergoing serial imaging during 2016. Electronic medical records were reviewed to determine their baseline age-adjusted CACI (age-CACI). After 4 years, their progression to WF, disease specific (pancreatic malignancy-related, DSM), extra-pancreatic (EPM), and overall mortalities (OM) were determined using Kaplan-Meir Survival Analysis.Abstract: RESULTS: 502 individuals underwent prospective surveillance. The study included 440 individuals with low-risk suspected or presumed mucinous cysts and excluded 50 and 12 individuals with WF and HRS respectively. Over a median follow-up of 56 months, 12 WF progressions, 2 DSMs, 42 EPMs, and 44 OMs were observed. Baseline age-CACI had good predictive capacity for 4-year EPM (Area-Under Curve: 0.87; p<.0001). The median age-CACI of 4 enabled cohort stratification into Low (age-CACI <4) and High CACI (age-CACI >=4) groups. A significantly higher OM (p<.001) was observed among the High CACI group as compared to the Low CACI group.Abstract: CONCLUSION: Through real-time application of CACI to patient outcomes, our analysis supports incorporation of this comorbidity assessment tool in making shared surveillance decisions among low-risk pancreatic cyst population. Copyright (c) 2020 AGA Institute. Published by Elsevier Inc. All rights reserved.