Risk factors for rebleeding and death from peptic ulcer in the very elderly

Chow, Louis W C; Gertsch, P; Poon, Ronnie T. P.; Branicki, Frank J.

doi:10.1046/j.1365-2168.1998.00665.x

Cited by 55 publications

(50 citation statements)

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“…In a prospective study of 1,744 patients treated for peptic ulcer bleeding in China, patients over 80 years of age were found to have a significantly increased risk of rebleeding compared with patients younger than 80 years [50]. A second study in the USA found the age of 60 years or older to be associated with a significant increase in the risk of rebleeding (OR: 8.0; 95% CI: 2.8–22.8) [37].…”

Section: Resultsmentioning

confidence: 99%

Systematic Review of the Epidemiology of Complicated Peptic Ulcer Disease: Incidence, Recurrence, Risk Factors and Mortality

Lau

Sung²,

Hill³

et al. 2011

Digestion

460

334

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Background/Aims: The incidence of uncomplicated peptic ulcer has decreased in recent years. It is unclear what the impact of this has been on the epidemiology of peptic ulcer complications. This systematic review aimed to determine the incidence, recurrence and mortality of complicated peptic ulcer and the risk factors associated with these events. Methods: Systematic PubMed searches. Results: Overall, 93 studies were identified. Annual incidence estimates of peptic ulcer hemorrhage and perforation were 19.4–57.0 and 3.8–14 per 100,000 individuals, respectively. The average 7-day recurrence of hemorrhage was 13.9% (95% CI: 8.4–19.4), and the average long-term recurrence of perforation was 12.2% (95% CI: 2.5–21.9). Risk factors for peptic ulcer complications and their recurrence included nonsteroidal anti-inflammatory drug and/or acetylsalicylic acid use, Helicobacter pylori infection and ulcer size ≧1 cm. Proton pump inhibitor use reduced the risk of peptic ulcer hemorrhage. Average 30-day mortality was 8.6% (95% CI: 5.8–11.4) after hemorrhage and 23.5% (95% CI: 15.5–31.0) after perforation. Older age, comorbidity, shock and delayed treatment were associated with increased mortality. Conclusions: Complicated peptic ulcer remains a substantial healthcare problem which places patients at a high risk of recurrent complications and death.

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Section: Resultsmentioning

confidence: 99%

Systematic Review of the Epidemiology of Complicated Peptic Ulcer Disease: Incidence, Recurrence, Risk Factors and Mortality

Lau

Sung²,

Hill³

et al. 2011

Digestion

460

334

View full text Add to dashboard Cite

show abstract

“…Except for the endoscopy itself, endoscopic treatment seems also to be an effective and generally safe treatment even when it is performed in the elderly [26,27] . In a previous study in elderly patients with peptic ulcer bleeding, no rebleeding or morbidity occurred when endoscopic treatment was performed early but there was a significantly greater risk of further bleeding and treatment related morbidity when treatment was performed after the onset of rebleeding [28] . On the other side, from the existing data, there is no evidence that peptic ulcer bleeding is more resistant to endoscopic therapy due to possible atherosclerosis of the underlying ar ter y.…”

Section: Discussionmentioning

confidence: 99%

Acute upper gastrointestinal bleeding in octοgenarians: Clinical outcome and factors related to mortality

Theocharis¹,

Arvaniti²,

Assimakopoulos³

et al. 2008

WJG

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AIM:To evaluate the aetiology, clinical outcome and factors related to mortality of acute upper gastrointestinal bleeding (AUGIB) in octogenarians. METHODS:We reviewed the records of all patients over 65 years old who were hospitalised with AUGIB in two hospitals from January 2006 to December of 2006. Patients were divided into two groups: Group A (65-80 years old) and Group B (> 80 years old). RESULTS: Fo u r h u n d re d a n d s i x t e e n p a t i e n t s over 65 years of age were hospitalized because of AUGIB. Group A included 269 patients and Group B 147 patients. Co-morbidity was more common in octogenarians (P = 0.04). The main cause of bleeding was peptic ulcer in both groups. Rebleeding and emergency surgery were uncommon in octogenarians and not different from those in younger patients. In-hospital complications were more common in octogenarians (P = 0.05) and more patients died in the group of octogenarians compared to the younger age group (P = 0.02). Inability to perform endoscopic examination (P = 0.002), presence of high risk for rebleeding stigmata (P = 0.004), urea on admission (P = 0.036), rebleeding (P = 0.004) and presence of severe co-morbidity (P < 0.0001) were related to mortality. In multivariate analysis, only the presence of severe co-morbidity was independently related to mortality (P = 0.032). CONCLUSION: While rebleeding and emergency surgery rates are relatively low in octogenarians with AUGIB, the presence of severe co-morbidity is the main factor of adverse outcome.

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“…The elderly are particularly susceptible to peptic ulcer disease (PUD) and complications due to their higher H. pylori prevalence and use of non-steroidal anti-inflammatory drugs (NSAIDs) (Bhala&Newton, 2005;Chow et al, 1998;Jones&Hawkey, 2001). Even if it is well known that the incidence of gastric ulcers increases in elderly people, little is known about gastric mucosal healing alterations during ageing.…”

Section: H Pylori Infection and Peptic Ulcer Diseasementioning

confidence: 99%

Helicobacter pylori Infection in Elderly Patients

Salles

2011

Peptic Ulcer Disease

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Risk factors for rebleeding and death from peptic ulcer in the very elderly

Cited by 55 publications

References 10 publications

Systematic Review of the Epidemiology of Complicated Peptic Ulcer Disease: Incidence, Recurrence, Risk Factors and Mortality

Systematic Review of the Epidemiology of Complicated Peptic Ulcer Disease: Incidence, Recurrence, Risk Factors and Mortality

Acute upper gastrointestinal bleeding in octοgenarians: Clinical outcome and factors related to mortality

Helicobacter pylori Infection in Elderly Patients

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