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Upper GI endoscopy in elderly patients: predictive factors of relevant endoscopic findings

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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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Authors and Affiliations

  1. Gastroenterology and Digestive Endoscopy Unit, Cattinara Hospital, Trieste, Italy

    Luigi Buri

  2. Gastroenterologia ed Endoscopia Digestiva, PTP Nuovo Regina Margherita, Via E. Morosini, 30, 00153, Rome, Italy

    Angelo Zullo, Cesare Hassan & Sergio Morini

  3. Gastrointestinal Endoscopy Service, Malatesta, Cesena, Italy

    Gianluca Bersani

  4. Gastroenterology Unit, Belcolle Hospital, Viterbo, Italy

    Marcello Anti

  5. Division of Gastroenterology and Digestive Endoscopy ASL NA5-Hospital Agostino Maresca, Torre del Greco, Italy

    Maria A. Bianco & Livio Cipolletta

  6. Digestive and Liver Disease Unit, Second Medical School, University “La Sapienza”, Sant’Andrea Hospital, Rome, Italy

    Emilio Di Giulio

  7. Gastroenterology Unit, “Saverio De Bellis” Hospital, Castellana Grotte, Bari

    Giovanni Di Matteo

  8. Gastroenterology, Policlinico G Martino, Messina, Italy

    Luigi Familiari

  9. Surgery and Oncology Department, “Università di Palermo”, Palermo, Italy

    Leonardo Ficano

  10. Endoscopy Unit, SS Trinità Hospital, Cagliari, Italy

    Piero Loriga

  11. Gastroenterology Unit, Policlinico La Sapienza, Rome, Italy

    Vincenzo Pietropaolo

  12. Gastroenterology Unit, Maggiore Hospital, Crema, Italy

    Alessandro Zambelli

  13. Bracco S.p.A., Medical Department, Milan, Italy

    Enzo Grossi

  14. Idea 99, Padua, Italy

    Francesco Tessari

  15. Semeion Research Centre for Sciences of Communication, Rome, Italy

    Marco Intraligi & Massimo Buscema

Authors
  1. Luigi Buri
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  2. Angelo Zullo
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  3. Cesare Hassan
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  4. Gianluca Bersani
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  5. Marcello Anti
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  6. Maria A. Bianco
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  7. Livio Cipolletta
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  8. Emilio Di Giulio
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  9. Giovanni Di Matteo
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  10. Luigi Familiari
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  11. Leonardo Ficano
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  12. Piero Loriga
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  13. Sergio Morini
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  14. Vincenzo Pietropaolo
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  15. Alessandro Zambelli
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  16. Enzo Grossi
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  17. Francesco Tessari
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  18. Marco Intraligi
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  19. Massimo Buscema
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Consortia

and the SIED Appropriateness Working Group

Corresponding author

Correspondence to Angelo Zullo.

Additional information

The members of the SIED Appropriateness Working Group are given in Appendix 1.

Appendices

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.

Appendix 2

See Table 5.

Table 5 List of the endoscopic findings regarded as “relevant” for the purpose of this study
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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

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