BACKGROUND: Impairment of activities of daily living (ADL) due to hemorrhagic gastroduodenal ulcers (HGU) has rarely been evaluated. We analyzed the risk factors of poor prognosis, including mortality and impairment of ADL, in patients with HGU. METHODS: In total, 582 patients diagnosed with HGU were retrospectively analyzed. Admission to a care facility or the need for home adaptations during hospitalization were defined as ADL decline. The clinical factors were evaluated: endoscopic features, need for interventional endoscopic procedures, comorbidities, symptoms, and medications. The risk factors of outcomes were examined with multivariate analysis. RESULTS: Advanced age (> 75 years) was a significant predictor of poor prognosis, including impairment of ADL. Additional significant risk factors were renal disease (odds ratio [OR] 3.43; 95% confidence interval [CI] 1.44-8.14) for overall mortality, proton pump inhibitor (PPIs) usage prior to hemorrhage (OR 5.80; 95% CI 2.08-16.2), and heart disease (OR 3.05; 95% CI 1.11-8.43) for the impairment of ADL. Analysis of elderly (> 75 years) subjects alone also revealed that use of PPIs prior to hemorrhage was a significant predictor for the impairment of ADL (OR 8.24; 95% CI 2.36-28.7). CONCLUSION: In addition to advanced age, the presence of comorbidities was a risk of poor outcomes in patients with HGU. PPI use prior to hemorrhage was a significant risk factor for the impairment of ADL, both in overall HGU patients and in elderly patients alone. These findings suggest that the current strategy for PPI use needs reconsideration.
BACKGROUND: Impairment of activities of daily living (ADL) due to hemorrhagic gastroduodenal ulcers (HGU) has rarely been evaluated. We analyzed the risk factors of poor prognosis, including mortality and impairment of ADL, in patients with HGU. METHODS: In total, 582 patients diagnosed with HGU were retrospectively analyzed. Admission to a care facility or the need for home adaptations during hospitalization were defined as ADL decline. The clinical factors were evaluated: endoscopic features, need for interventional endoscopic procedures, comorbidities, symptoms, and medications. The risk factors of outcomes were examined with multivariate analysis. RESULTS: Advanced age (> 75 years) was a significant predictor of poor prognosis, including impairment of ADL. Additional significant risk factors were renal disease (odds ratio [OR] 3.43; 95% confidence interval [CI] 1.44-8.14) for overall mortality, proton pump inhibitor (PPIs) usage prior to hemorrhage (OR 5.80; 95% CI 2.08-16.2), and heart disease (OR 3.05; 95% CI 1.11-8.43) for the impairment of ADL. Analysis of elderly (> 75 years) subjects alone also revealed that use of PPIs prior to hemorrhage was a significant predictor for the impairment of ADL (OR 8.24; 95% CI 2.36-28.7). CONCLUSION: In addition to advanced age, the presence of comorbidities was a risk of poor outcomes in patients with HGU. PPI use prior to hemorrhage was a significant risk factor for the impairment of ADL, both in overall HGUpatients and in elderly patients alone. These findings suggest that the current strategy for PPI use needs reconsideration.
Entities:
Keywords:
Activity of daily living; Elderly; Gastroduodenal ulcer; Prognosis
Authors: Riccardo Marmo; Maurizio Koch; Livio Cipolletta; Lucio Capurso; Angelo Pera; Maria A Bianco; Rodolfo Rocca; Angelo Dezi; Renato Fasoli; Sergio Brunati; Ivano Lorenzini; Ugo Germani; Giovanni Di Matteo; Paolo Giorgio; Giorgio Imperiali; Giorgio Minoli; Fausto Barberani; Sandro Boschetto; Marco Martorano; Giovanni Gatto; Mariano Amuso; Alfredo Pastorelli; Elena S Torre; Omero Triossi; Andrea Buzzi; Renzo Cestari; Domenico Della Casa; Massimo Proietti; Anna Tanzilli; Giovanni Aragona; Francesco Giangregorio; Luciano Allegretta; Salvatore Tronci; Paolo Michetti; Paola Romagnoli; Andrea Nucci; Francesca Rogai; Walter Piubello; Maria Tebaldi; Fabrizio Bonfante; Alessandro Casadei; Claudio Cortini; Giorgio Chiozzini; Lisa Girardi; Claudio Leoci; Giampiero Bagnalasta; Sergio Segato; Giuseppe Chianese; Mario Salvagnini; Gianluca Rotondano Journal: Am J Gastroenterol Date: 2008-07 Impact factor: 10.864
Authors: Alfonso J Cruz-Jentoft; Jean Pierre Baeyens; Jürgen M Bauer; Yves Boirie; Tommy Cederholm; Francesco Landi; Finbarr C Martin; Jean-Pierre Michel; Yves Rolland; Stéphane M Schneider; Eva Topinková; Maurits Vandewoude; Mauro Zamboni Journal: Age Ageing Date: 2010-04-13 Impact factor: 10.668
Authors: Antonio Tarasconi; Federico Coccolini; Walter L Biffl; Matteo Tomasoni; Luca Ansaloni; Edoardo Picetti; Sarah Molfino; Vishal Shelat; Stefania Cimbanassi; Dieter G Weber; Fikri M Abu-Zidan; Fabio C Campanile; Salomone Di Saverio; Gian Luca Baiocchi; Claudio Casella; Michael D Kelly; Andrew W Kirkpatrick; Ari Leppaniemi; Ernest E Moore; Andrew Peitzman; Gustavo Pereira Fraga; Marco Ceresoli; Ronald V Maier; Imtaz Wani; Vittoria Pattonieri; Gennaro Perrone; George Velmahos; Michael Sugrue; Massimo Sartelli; Yoram Kluger; Fausto Catena Journal: World J Emerg Surg Date: 2020-01-07 Impact factor: 5.469