Mortality rate and risk factors for gastrointestinal bleeding in elderly patients

Marco Vincenzo Lenti, Luca Pasina, Sara Cococcia, Laura Cortesi, Emanuela Miceli, Costanza Caccia Dominioni, Martina Pisati, Caterina Mengoli, Francesco Perticone, Alessandro Nobili, Antonio Di Sabatino, Gino Roberto Corazza, REPOSI Investigators

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Gastrointestinal bleeding (GIB) is burdened by high mortality rate that increases with aging. Elderly patients may be exposed to multiple risk factors for GIB. We aimed at defining the impact of GIB in elderly patients. METHODS: Since 2008, samples of elderly patients (age ≥ 65 years) with multimorbidity admitted to 101 internal medicine wards across Italy have been prospectively enrolled and followed-up (REPOSI registry). Diagnoses of GIB, length of stay (LOS), mortality rate, and possible risk factors, including drugs, index of comorbidity (Cumulative Illness Rating Scale [CIRS]), polypharmacy, and chronic diseases were assessed. Adjusted multivariate logistic regression models were computed. RESULTS: 3872 patients were included (mean age 79 ± 7.5 years, F:M ratio 1.1:1). GIB was reported in 120 patients (mean age 79.6 ± 7.3 years, F:M 0.9:1), with a crude prevalence of 3.1%. Upper GIB occurred in 72 patients (mean age 79.3 ± 7.6 years, F:M 0.8:1), lower GIB in 51 patients (mean age 79.4 ± 7.1 years, F:M 0.9:1), and both upper/lower GIB in 3 patients. Hemorrhagic gastritis/duodenitis and colonic diverticular disease were the most common causes. The LOS of patients with GIB was 11.7 ± 8.1 days, with a 3.3% in-hospital and a 9.4% 3-month mortality rates. Liver cirrhosis (OR 5.64; CI 2.51-12.65), non-ASA antiplatelet agents (OR 2.70; CI 1.23-5.90), and CIRS index of comorbidity >3 (OR 2.41; CI 1.16-4.98) were associated with GIB (p 
Original languageEnglish
Pages (from-to)54-61
Number of pages8
JournalEuropean Journal of Internal Medicine
Volume61
DOIs
Publication statusPublished - Mar 2019

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Keywords

  • *Anemia
  • *Anticoagulant
  • *Antiplatelet drug
  • *Diverticulosis
  • *Gastric ulcer
  • *Multimorbidity
  • Aged
  • Aged, 80 and over
  • Female
  • Gastrointestinal Hemorrhage/etiology/*mortality
  • Hospital Mortality
  • Humans
  • Italy/epidemiology
  • Length of Stay/*statistics & numerical data
  • Logistic Models
  • Male
  • Multivariate Analysis
  • Platelet Aggregation Inhibitors/adverse effects
  • Prospective Studies
  • Registries
  • Risk Factors
  • Severity of Illness Index

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