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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The members of the SIED Appropriateness Working Group are given in Appendix 1.
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Appendix 1: The members of the SIED Appropriateness Working Group
Costa G (Ospedale di Tortona—ASL 20, Piemonte); Grassini M, Niola P (Ospedale “Cardinal Massaia”, Asti); Carmagnola S (Ospedale Maggiore della Carità, Novara); Allegretti A, Vallarino E (E.O. Ospedali Galliera, Genova); Leoci C, Popovic A (Ospedale di Manerbio—A.O. Desenzano G., Brescia); Snider L, Bellini O (Azienda Ospedaliera “S. Anna”, Como); Manes G (Azienda Ospedaliera “L. Sacco”, Milano); Lancini GP, Cestari R (Spedali Civili di Brescia, Brescia); Centenaro R, Boni F (Ospedale Civile di Melegnano, Milano); Gebbia C, Iollo P (Ospedale “Città di Sesto S. Giovanni”, Milano); Bertozzo A, Piazzi L (Ospedale Civile, Bolzano); Bottona E, Pantalena M (ULSS 5 Veneto, Vicenza); Battaglia L, Marino S (Ospedale Piove di Sacco ULSS 14- Chioggia, Padova); Ntakirutimana E (Ospedale “G. Fracastoro”—S. Bonifacio—ULSS 20, Verona); Marcon V (Ospedale Civile Agordo, Belluno); Marin R, Cervellini E (Ospedale Di Dolo, Venezia); Okolicsanyi L, Monica F (Ospedale Regionale—ULSS 9, Treviso); Cappiello R, Sablich R (Ospedale S. Maria degli Angeli, Pordenone); Simeth C (Ospedale Cattinara, Trieste); Zilli M (Ospedale Santa Maria della Misericordia, Udine); Trande P, De Martinis E (Nuovo Ospedale Civile S. Agostino Estense, Modena); Merighi A, Boarino V (Azienda Ospedaliera Universitaria Policlinico, Modena); Cortini C, Maltoni S (Ospedale G.B. Morgagni, Forli’); Rossi A (Casa di Cura “Malatesta—Novello”, Cesena); Frosini G, Longobardi L (Azienda Ospedaliera Universitaria Senese “S. Maria delle Scotte”, Siena); Macri’ G, Dabiozzi E (Azienda Ospedaliera Universitaria “Careggi”, Firenze); Pincione F, Widamayer C (ASL 1—Ospedale Civico, Massa); Tatali M (AUSL Marche—Zona Territoriale 2 Urbino, Pesaro); Ferrini G (Ospedale “F. Renzetti”, Chieti); Neri M, La Terza F (Ospedale Clinicizzato SS. Annunziata, Chieti); Spadaccini A, Silla M (Ospedale “San Pio da Pietrelcina”, Chieti); Pastorelli A (Ospedale “Belcolle”, Viterbo); Spada C, Petruzziello L, Costamagna G (Università Cattolica del Sacro Cuore “Policlinico A. Gemelli”, Roma); Gabbrielli A, Di Matteo F (Università Campus “Bio Medico”, Roma); Lorenzetti R (Ospedale “Nuovo Regina Margherita”, Roma); Onorato M, Policlinico Umberto I, Roma); Stroppa I, Andrei F (Policlinico Tor Vergata, Roma); Grimaldi E, De Filippo FR (Ospedale Civile—A.O. Caserta, Caserta); Di Giorgio P, Giannatasio F (Ospeale “S.Maria di Loreto—Mare”, Napoli); Piscopo R (Ospedale Evangelico “Villa Betania”, Napoli); Ingrosso M, Spera G (Università Cattolica del Sacro Cuore, Campobasso); Fregola G, Quatraro F (Ente Ecclesiastico Osp. Reg. “F.Miulli”, Bari); De Maio G, Corazza L (Ospedale “Madonna delle Grazie”, Matera); Giglio A, Rodino’ S (Ospedale “Pugliese—Ciaccio”, Cosenza); Iaquinta L (ASL 5 Crotone, Cosenza); Ciliberto E, Cavaliere C (Ospedale S. Giovanni di Dio, Crotone); Fatta MF, Stiriti A (Ospedale Civile “Scilla”, Reggio Calabria); Assenza G (Ospedale “E. Muscatello”, Siracusa); Brancato FP (Ospedale di Alcamo, Trapani); Tortora A, Giacobbe G (Policlinico Universitario “G. Martino”, Messina); Italy.
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Buri, L., Zullo, A., Hassan, C. et al. Upper GI endoscopy in elderly patients: predictive factors of relevant endoscopic findings. Intern Emerg Med 8, 141–146 (2013). https://doi.org/10.1007/s11739-011-0598-3
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DOI: https://doi.org/10.1007/s11739-011-0598-3