Mujkanović, Amer

Objectives Optimal use of surgery first (SF) vs neoadjuvant therapy (NAT) for localized pancreatic ductal adenocarcinoma (PDAC) is still unclear. There is concern that NAT may result in worsened post-operative outcomes. Our study objectives were to show the impact of NAT on post-operative morbidity and mortality. Methods All patients undergoing resection for PDAC between 1/1/2010 and 12/31/2020 were reviewed and those who underwent pancreaticoduodenectomy (PD) were included. Demographics, perioperative details, and pathology details were gathered. Data pertaining to 90-day complications were obtained and graded according to international consensus guidelines. Those undergoing SF were compared to those who had NAT. Categorical variables were compared by Fisher’s exact test and continuous variables by Student’s t-test. Results Two hundred and forty-one subjects who underwent PD for PDAC were included in this review. There was no significant difference in the rate of major morbidity between subjects who received NAT vs SF (19.4 vs 20.3%, P = 1.0). Similarly, there were no significant differences in the rates of mortality (3.1 vs 4.2%, P = .742), post-operative pancreatic fistula (8.2 vs 10.5%, P = .658), or post-pancreatectomy hemorrhage (7.1 vs 7.7%, P = 1.0), respectively. Conclusion Post-operative outcomes are not worsened by the use of the NAT approach prior to PD for PDAC. Further investigation is needed to reveal which patient subgroups may benefit from the use of NAT, especially regarding survival.

Abstract Background Since the outbreak of COVID-19 pandemic, clinical data from various parts of the world have been reported. Until now, there has been no clinical data with regards to COVID-19 from Bosnia and Herzegovina (B&H). The aim was to report on the first cohort of patients from B&H and to analyze clinical factors of COVID-19 patients that have influenced the length of hospitalization (LOH) of COVID-19 infected patients.Methods This retrospective cohort study was conducted at Tuzla University Clinical Center (UKC). It included 25 COVID-19 positive patients that were hospitalized between March 28th and April 27th 2020. The LOH was measured from the time of admission to discharge. Factors analyzed induced age, BMI, presence of known comorbidities, serum creatinine and O2 saturation upon admission.Results The mean age was 52.92±19.15 years and BMI 28.80±4.22. LOH for patients with BMI <25 was 9± SE2.646 days (CI 95% 3.814-14.816) vs 14.182 ±SE .937 (CI 95% 12.346-16.018 p<0.05; HR 5.148 CI95% 1.217 to 21.772 p=0.026) for ≥25 BMI. The mean LOH of patients with normal levels of O2 ≥95% was 11.667 ±SE1.202 (CI95% 8.261 to 13.739; p=0.046), while LOH for patients with <95% was 14.625 ±SE 1.231 CI95% 12.184 to 16.757 p=0.042; HR 3.732 CI95%1.137-12.251 p=0.03). Patients without known comorbidities had a mean LOH of 11.700± SE1.075 (CI 95% 9.592-13.808), while those with comorbidities had a mean of 14.8±1.303 (CI 95% 12.247-17.353; p=0.029) with HR2.552Conclusion LOH varied among COVID-19 patients and was prolonged when clinical characteristics such as BMI, known comorbidities, elevated creatinine, and O2 saturation <95% were present. Furthermore, risk factors for COVID-19 patients in B&H do not deviate from those reported in other countries.

Abstract Background Since the outbreak of COVID-19 pandemic clinical data from various parts of the world have been reported; until now, there has been no clinical data with regards to COVID-19 from Bosnia and Herzegovina (B&H). The aim was to report on the first cohort of patients from B&H and to analyze clinical factors of COVID-19 patients that may influence the length of hospitalization (LOH) of COVID-19 infected patients.Methods Retrospective cohort study was conducted at Tuzla University Clinical Center (UKC). It included 25 COVID-19 positive patients that were hospitalized between March 28th and April 27th 2020. The LOH was measured from the time of admission to discharge. Factors analyzed induced age, BMI, presence of comorbidities, serum creatinine and oxygen saturation upon admission.Results The mean age was 52.92±19.15 years and BMI 28.80±4.22. LOH for patients with normal BMI was 9±SE2.646 days (CI 95% 3.814-14.816) vs 14.182 ±SE .937 (CI 95% 12.346-16.018; p<0.05) for ≥25 BMI. Patients without underlying diseases had a LOH of 11.70 ±SE1.075 (CI 95% 9.592-13.808), while those with comorbidities 14.8 ±SE1.303 (CI95% 12.247-17.353; p<0.05). Conclusion LOH varied among COVID-19 patients and was prolonged when clinical characteristics such as elevated BMI, presence of comorbidities, elevated creatinine and low oxygen saturation levels were taken into consideration. Furthermore, risk factors for COVID-19 patients in B&H do not deviate from data reported in other countries.

Abstract Background Since outbreak of COVID-19 pandemic clinical data from various parts of the world have been reported, until now there has been no provide data from Bosnia and Herzegovina (B&H) about COVID-19. Aim was to report on the first cohort of patients from B&H and to analyze clinical factors of COVID-19 patients that influence the length of hospitalization. Methods Retrospective cohort study conducted at UKC Tuzla. The study included 25 COVID-19 positive patients that were hospitalized between March 28th and April 27th 2020. The LOH was measured from the time of admission to discharge. Hospitalization greater than 10 days was considered as prolonged. Factors analyzed induced age, BMI, comorbidities, serum creatinine and oxygen saturation upon admission.Results The mean age was 52.92±19.15 years and BMI 28.80±4.22. LOH for patients with normal BMI was 9±SE2.646 days (CI 95% 3.814-14.816) vs 14.182 ±SE .937 (CI 95% 12.346-16.018; p<0.05) for ≥25 BMI. Patients without underlying diseases had a LOH of 11.70 ±SE1.075 (CI 95% 9.592-13.808), while those with comorbidities 14.8 ±SE1.303 (CI95% 12.247-17.353; p<0.05). Conclusion LOH varied among COVID-19 patients and was prolonged when clinical characteristics such as elevated BMI, comorbidities, elevated creatinine and low oxygen saturation levels were taken into consideration. Furthermore, risk factors for COVID-19 patients in B&H do not deviate from data reported in other countries.