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

TitleRisk factors for rebleeding and death from peptic ulcer in the very elderly
Authors
Issue Date1998
PublisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://www.bjs.co.uk
Citation
British Journal Of Surgery, 1998, v. 85 n. 1, p. 121-124 How to Cite?
AbstractBackground: Ageing populations are increasing in many countries and bleeding peptic ulcers in patients older than 60 years carry a greater risk of rebleeding and death. This study aimed to identify the risk factors for rebleeding and death in very elderly patients with peptic ulcer bleeding. The efficacy of treatment in preventing recurrent bleeding and death in this group of patients was also studied by means of prospective data collection and analysis. Methods: Data relating to 1744 patients treated between September 1985 and January 1994 for peptic ulcer bleeding were collected prospectively and analysed. Patients were stratified by age to one of three groups: group 1 (less than 60 years, n = 833), group 2 (60-79 years, n = 706) and group 3 (80 or more years, n = 205). Results: Univariate and multivariate analyses of 21 factors possibly affecting either rebleeding or death identified age greater than 80 years as one of the factors significantly affecting rebleeding and death. In a comparison of groups 1, 2 and 3, the likelihood of rebleeding and death was significantly greater in group 3. Univariate and multivariate analyses for rebleeding and death were performed for each group. The severity of initial bleeding had a marked bearing on subsequent rebleeding rates for all three groups. In group 3, however, large ulcer size and impaired liver function were additional factors which correlated significantly with final outcome. No rebleeding or morbidity occurred when endoscopic treatment was performed early for patients in group 3 but there was a significantly greater risk of further recurrent haemorrhage and treatment-related morbidity when treatment was performed after the onset of rebleeding. Conclusion: Patients aged 80 years or greater had the highest risk of rebleeding and death. For patients below 80 years of age, significant factors related to a fatal outcome included co-morbid illness, complications and the need for mechanical ventilation. For patients aged 80 years or older, the significant factors were ulcer size greater than 2 cm and admission with serum bilirubin level above 20 mmol/l. Endoscopic treatment for the very elderly was effective if carried out early.
Persistent Identifierhttp://hdl.handle.net/10722/83409
ISSN
2015 Impact Factor: 5.596
2015 SCImago Journal Rankings: 2.966
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChow, LWCen_HK
dc.contributor.authorGertsch, Pen_HK
dc.contributor.authorPoon, RTPen_HK
dc.contributor.authorBranicki, FJen_HK
dc.date.accessioned2010-09-06T08:40:41Z-
dc.date.available2010-09-06T08:40:41Z-
dc.date.issued1998en_HK
dc.identifier.citationBritish Journal Of Surgery, 1998, v. 85 n. 1, p. 121-124en_HK
dc.identifier.issn0007-1323en_HK
dc.identifier.urihttp://hdl.handle.net/10722/83409-
dc.description.abstractBackground: Ageing populations are increasing in many countries and bleeding peptic ulcers in patients older than 60 years carry a greater risk of rebleeding and death. This study aimed to identify the risk factors for rebleeding and death in very elderly patients with peptic ulcer bleeding. The efficacy of treatment in preventing recurrent bleeding and death in this group of patients was also studied by means of prospective data collection and analysis. Methods: Data relating to 1744 patients treated between September 1985 and January 1994 for peptic ulcer bleeding were collected prospectively and analysed. Patients were stratified by age to one of three groups: group 1 (less than 60 years, n = 833), group 2 (60-79 years, n = 706) and group 3 (80 or more years, n = 205). Results: Univariate and multivariate analyses of 21 factors possibly affecting either rebleeding or death identified age greater than 80 years as one of the factors significantly affecting rebleeding and death. In a comparison of groups 1, 2 and 3, the likelihood of rebleeding and death was significantly greater in group 3. Univariate and multivariate analyses for rebleeding and death were performed for each group. The severity of initial bleeding had a marked bearing on subsequent rebleeding rates for all three groups. In group 3, however, large ulcer size and impaired liver function were additional factors which correlated significantly with final outcome. No rebleeding or morbidity occurred when endoscopic treatment was performed early for patients in group 3 but there was a significantly greater risk of further recurrent haemorrhage and treatment-related morbidity when treatment was performed after the onset of rebleeding. Conclusion: Patients aged 80 years or greater had the highest risk of rebleeding and death. For patients below 80 years of age, significant factors related to a fatal outcome included co-morbid illness, complications and the need for mechanical ventilation. For patients aged 80 years or older, the significant factors were ulcer size greater than 2 cm and admission with serum bilirubin level above 20 mmol/l. Endoscopic treatment for the very elderly was effective if carried out early.en_HK
dc.languageengen_HK
dc.publisherJohn Wiley & Sons Ltd. The Journal's web site is located at http://www.bjs.co.uken_HK
dc.relation.ispartofBritish Journal of Surgeryen_HK
dc.rightsBritish Journal of Surgery. Copyright © John Wiley & Sons Ltd.en_HK
dc.titleRisk factors for rebleeding and death from peptic ulcer in the very elderlyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0007-1323&volume=85&spage=121&epage=124&date=1998&atitle=Risk+factors+for+rebleeding+and+death+from+peptic+ulcer+in+the+very+elderlyen_HK
dc.identifier.emailPoon, RTP: poontp@hkucc.hku.hken_HK
dc.identifier.authorityPoon, RTP=rp00446en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1046/j.1365-2168.1998.00665.xen_HK
dc.identifier.pmid9462402-
dc.identifier.scopuseid_2-s2.0-0031963035en_HK
dc.identifier.hkuros30040en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0031963035&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume85en_HK
dc.identifier.issue1en_HK
dc.identifier.spage121en_HK
dc.identifier.epage124en_HK
dc.identifier.isiWOS:000071500800032-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridChow, LWC=7202532995en_HK
dc.identifier.scopusauthoridGertsch, P=35458223300en_HK
dc.identifier.scopusauthoridPoon, RTP=7103097223en_HK
dc.identifier.scopusauthoridBranicki, FJ=7003617514en_HK

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