Favorable prognosis of upper-gastrointestinal bleeding in 1041 older patients: results of a prospective multicenter study.
| Autor: | Nahon S; Centre Hospitalier Montfermei, Montfermeil, France. snahon@ch-montfermeil.fr, Nouel O, Hagège H, Cassan P, Pariente A, Combes R, Kerjean A, Doumet S, Cocq-Vezilier P, Tielman G, Paupard T, Janicki E, Bernardini D, Antoni M, Haioun J, Pillon D, Bretagnolle P |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association [Clin Gastroenterol Hepatol] 2008 Aug; Vol. 6 (8), pp. 886-92. Date of Electronic Publication: 2008 Jun 04. |
| DOI: | 10.1016/j.cgh.2008.02.064 |
| Abstrakt: | Background & Aims: Upper-gastrointestinal bleeding (UGIB) in the elderly is associated with high morbidity and mortality. The aims of this study were to determine the prognostic factors of UGIB in a large cohort of elders. Methods: From March 2005 to February 2006, we conducted a prospective multicenter study in 53 French hospitals that consecutively enrolled 3287 patients for UGIB. A total of 1041 patients (47.8% women) were older than 74 years. Their epidemiologic characteristics and prognosis were compared with the 2246 younger patients (26.8% women). Results: Elders more frequently took drugs causing UGIB: 65% versus 32% for younger patients (P < 10(-6)). Peptic ulcers, erosive gastritis, and esophagitis accounted for 63.6% of UGIB causes in elders versus 39.7% in younger patients (P < 10(-4)). Conversely, esogastric varices and gastropathy were responsible for 11% of UGIB in elders versus 44% in younger patients (P < 10(-6)). The rebleeding rate, morbidity, and in-hospital mortality were not statistically different between elders and younger patients: 11.8% versus 9.7% (P = .07), 22.6% versus 21.6% (P = .5), and 8.9% versus 8.2% (P = .5), respectively. Transfusion requirements, need for surgery, and length of stay were significantly different between elders and younger patients: 73% versus 57.5% (P < 10(-6)), 4% versus 2.5% (P < .02), 10.6 +/- 15.6 versus 8.5 +/- 12.4 days (P < 10(-6)), respectively. Whatever the etiology (peptic lesions or portal hypertension) in-hospital mortality was the same: 6.5% versus 7.3% and 10.9% versus 11.3%, respectively. Conclusions: Elders can do as well as younger patients with acute UGIB. Although the reasons are not completely clear, they may be related to differences in treatment. |
| Databáze: | MEDLINE |
| Externí odkaz: |
|