Korean J Gastroenterol.  2009 May;53(5):297-304. 10.4166/kjg.2009.53.5.297.

Comparison of Clinical Characteristics and Outcomes between Geriatric and Non-geriatric Patients in Peptic Ulcer Bleeding

• Na YJ
• Shim KN
• Kang MJ
• Jung JM
• Kim SE
• Jung SA
• Yoo K
• Moon IH

• KMID: 1767687
• DOI: http://doi.org/10.4166/kjg.2009.53.5.297

Abstract

BACKGROUND/AIMS: In geriatric patients with peptic ulcer, the use of NSAID and prevalence of chronic illness have been increased, but the Helicobacter pylori (H. pylori) infected portion decreased. The aim of this study was to evaluate the clinical characteristics and outcomes of geriatric patients (aged 65 or older) with peptic ulcer bleeding and compare with non-geriatric patients (less than 65 years old).
METHODS
We conducted a retrospective study of 88 patients with peptic ulcer bleeding treated with therapeutic endoscopy from January 2006 to December 2006. We compared the clinical characteristics and outcomes of geriatric patients (n=34, 38.6%) with those of non-geriatric patients (n=54, 61.4%).
RESULTS
Hypertension (52.9% vs. 24.1%), cardiovascular disease (35.3% vs. 13.0%), and chronic obstructive pulmonary disease (20.6% vs. 3.7%) were more prevalent in the geriatric group, compared with the non-geriatric group (p<0.05). The geriatric group had taken more ulcerogenic drugs than the non-geriatric group (64.7% vs. 33.3%, p<0.05); aspirin plus clopidogrel (23.6% vs. 13.0%) and aspirin (20.6% vs. 11.0%). Sixteen (21.1%) of the 76 cases had H. pylori-negative ulcer. Between the two groups, there was no difference in the prevalence of H. pylori-negative ulcer (25.9% vs. 18.4%, p>0.05). The amount of transfusion length of ICU stay, rebleeding rate, operation rate and mortality were not different between the two groups. The length of hospital stay in the geriatric patients was significantly longer than the non-geriatric group (12.3+/-10.6 vs. 7.2+/-5.9 days, p<0.05). In multiple regression analysis, old age was a significant risk factor for longer hospital stay (p<0.05).
CONCLUSIONS
The geriatric patients with bleeding peptic ulcer had longer hospital stay than the non-geriatric patients in our study. The important emerging etiologies such as ulcerogenic drug and associated chronic illness should be checked and treated in these patients.

Keyword

Peptic ulcer bleeding; Geriatrics; Chronic illness; Drug

MeSH Terms

Adult
Age Factors
Aged
Aged, 80 and over
Duodenal Ulcer/*diagnosis/surgery/therapy
Female
Humans
Length of Stay
Male
Medication Adherence
Middle Aged
Peptic Ulcer Hemorrhage/*diagnosis/surgery/therapy
Retrospective Studies
Stomach Ulcer/*diagnosis/surgery/therapy
Treatment Outcome

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