Literature DB >> 21538157

Upper GI endoscopy in elderly patients: predictive factors of relevant endoscopic findings.

Luigi Buri1, Angelo Zullo, Cesare Hassan, Gianluca Bersani, Marcello Anti, Maria A Bianco, Livio Cipolletta, Emilio Di Giulio, Giovanni Di Matteo, Luigi Familiari, Leonardo Ficano, Piero Loriga, Sergio Morini, Vincenzo Pietropaolo, Alessandro Zambelli, Enzo Grossi, Francesco Tessari, Marco Intraligi, Massimo Buscema.   

Abstract

Elderly patients are at increased risk for peptic ulcer and cancer. Predictive factors of relevant endoscopic findings at upper endoscopy in the elderly are unknown. This was a post hoc analysis of a nationwide, endoscopic study. A total of 3,147 elderly patients were selected. Demographic, clinical, and endoscopic data were systematically collected. Relevant findings and new diagnoses of peptic ulcer and malignancy were computed. Both univariate and multivariate analyses were performed. A total of 1,559 (49.5%), 213 (6.8%), 93 (3%) relevant findings, peptic ulcers, and malignancies were detected. Peptic ulcers and malignancies were more frequent in >85-year-old patients (OR 3.1, 95% CI = 2.0-4.7, p = 0.001). The presence of dysphagia (OR = 5.15), weight loss (OR = 4.77), persistent vomiting (OR = 3.68), anaemia (OR = 1.83), and male gender (OR = 1.9) were significantly associated with a malignancy, whilst overt bleeding (OR = 6.66), NSAIDs use (OR = 2.23), and epigastric pain (OR = 1.90) were associated with the presence of peptic ulcer. Peptic ulcer or malignancies were detected in 10% of elderly patients, supporting the use of endoscopy in this age group. Very elderly patients appear to be at higher risk of such lesions.

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Year:  2011        PMID: 21538157     DOI: 10.1007/s11739-011-0598-3

Source DB:  PubMed          Journal:  Intern Emerg Med        ISSN: 1828-0447            Impact factor:   3.397


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