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

来源：

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY | 2008年 / 6卷 / 08期

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

页码：886 / 892

页数：7

共 24 条

[1]

Newer endoscopic therapies decrease both re-bleeding and mortality in high-risk patients with acute peptic ulcer bleeding: A series of meta-analyses [J].