Favorable prognosis of upper-gastrointestinal bleeding in 1041 older patients:: Results of a prospective multicenter study

被引:42
作者
Nahon, Stephane [1 ]
Nouel, Olivier [2 ]
Hagege, Herve [3 ]
Cassan, Philippe [4 ]
Parente, Alexandre [5 ]
Combes, Remi [6 ]
Kerjean, Alain [7 ]
Doumet, Sylva [8 ]
Coco-Vezilier, Perrine [9 ]
Tielman, Guillaume [10 ]
Paupard, Thierry [11 ]
Janicki, Eric [12 ]
Bernardini, David [13 ]
Antoni, Michel [14 ]
Haioun, Jajjia [15 ]
Pillon, Didier [16 ]
Bretagnolle, Philippe [17 ]
机构
[1] Ctr Hosp Montfermei, Montfermeil, France
[2] Ctr Hosp St Brieuc, St Brieuc, France
[3] Ctr Hosp Intercommunal, Creteil, France
[4] Ctr Hosp Vichy, Vichy, France
[5] Ctr Hosp Pau, Pau, France
[6] Ctr Hosp Moulins, Moulins, France
[7] Ctr Hosp Lorient, Lorient, France
[8] Ctr Hosp Villeneuve St Georges, Villeneuve St Georges, France
[9] Ctr Hosp Douai, Douai, France
[10] Hop Victor Provo Roubaix, Roubaix, France
[11] Ctr Hosp Dunkerque, Dunkerque, France
[12] Ctr Hosp Arras, Arras, France
[13] Ctr Hosp Toulon, Toulon, France
[14] Ctr Hosp Orange, Orange, France
[15] Ctr Hosp Cavaillon, Cavaillon, France
[16] Ctr Hosp Bourg Bresse, Bourg En Bresse, France
[17] Ctr Hosp Chambery, Chambery, France
关键词
D O I
10.1016/j.cgh.2008.02.064
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
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.
引用
收藏
页码:886 / 892
页数:7
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