Usefulness of the comprehensive geriatric assessment in older patients with upper gastrointestinal bleeding: a two-year follow-up study.

Usefulness of the comprehensive geriatric assessment in older patients with upper gastrointestinal bleeding: a two-year follow-up study. Research Abstract Details 

Research Abstract Table of Contents

Jump to the:

Usefulness of the comprehensive geriatric assessment in older patients with upper gastrointestinal bleeding: a two-year follow-up study. Abstract Text:

BACKGROUND: The potential usefulness of standardized comprehensive geriatric assessment (CGA) in evaluating treatment and follow-up of older patients with upper gastrointestinal bleeding is unknown. Aim: To evaluate the usefulness of the CGA as a 2-year mortality multidimensional prognostic index (MPI) in older patients hospitalized for upper gastrointestinal bleeding. MATERIALS AND METHODS: Patients aged > or =65 years consecutively hospitalized for acute upper gastrointestinal bleeding were included. Diagnosis of bleeding was based on clinical and endoscopic features. All patients underwent a CGA that included six standardized scales, i.e., Activities of Daily Living (ADL), Instrumental Activities of Daily Living (IADL), Short Portable Mental Status Questionnaire (SPMSQ), Mini Nutritional Assessment (MNA), Exton-Smith Score (ESS) and Comorbity Index Rating Scale (CIRS), as well as information on medication history and cohabitation, for a total of 63 items. A MPI was calculated from the integrated total scores and expressed as MPI 1 = low risk, MPI 2 = moderate risk, and MPI 3 = severe risk. The predictive value of the MPI for mortality over a 24-month follow-up was calculated. RESULTS: 36 elderly patients (M 16/F 20, mean age 82.8 +/- 7.9 years, range 70-101 years) were included in the study. A significant difference in mean age was observed between males and females (M 80.1 +/- 4.8 vs. F 84.9 +/- 9.3 years; p < 0.05). The causes of upper gastrointestinal bleeding were duodenal ulcer in 38.8%, gastric ulcer in 22.2%, and erosive gastritis in 16.6% of the patients, while 16.6% had gastrointestinal bleeding from unknown origin. The overall 2-year mortality rate was 30.5%. 18 patients (50%) were classified as having a low-risk MPI (mean value 0.18 +/- 0.09), 12 (33.3%) as having a moderate-risk MPI (mean value 0.48 +/- 0.08) and 6 (16.6%) as having a severe-risk MPI (mean value 0.83 +/- 0.06). Higher MPI grades were significantly associated with higher mortality (grade 1 = 12.5%, grade 2 = 41.6%, grade 3 = 83.3%; p = 0.001). Adjusting for age and sex, the prognostic efficacy of MPI for mortality was confirmed and highly significant (odds ratio 10.47, 95% CI 2.04-53.6). CONCLUSION: CGA is a useful tool for calculating a MPI that significantly predicts the risk of 2-year mortality in older patients with upper gastrointestinal bleeding.

Usefulness of the comprehensive geriatric assessment in older patients with upper gastrointestinal bleeding: a two-year follow-up study. Publishing Authors By Initials

For similar natural sciences: time: time factors research abstracts see: natural sciences: time: time factors research

PUBMED ID PMID:

MEDLINE DATE:

Usefulness of the comprehensive geriatric assessment in older patients with upper gastrointestinal bleeding: a two-year follow-up study. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Digestive diseases (Basel, Switzerland)

VOLUME: 25

Page Numbers: 124-8

Journal Abbreviation:

ISSN: 1421-9875

DAY: 7

MONTH: 04

YEAR: 2007

Usefulness of the comprehensive geriatric assessment in older patients with upper gastrointestinal bleeding: a two-year follow-up study. Information

Number of References:

LANGUAGE: eng

NlmUniqueID: 8701186

Usefulness of the comprehensive geriatric assessment in older patients with upper gastrointestinal bleeding: a two-year follow-up study. Keywords Mesh Terms:

KEYWORDS: Time Factors

MESH TERMS: therapy

Chemical & Substance for Abstract: Usefulness of the comprehensive geriatric assessment in older patients with upper gastrointestinal bleeding: a two-year follow-up study. Information

Substance Name:

Registry Number:

Grant and Affiliation Information for Usefulness of the comprehensive geriatric assessment in older patients with upper gastrointestinal bleeding: a two-year follow-up study.

AFFILIATION: Geriatric Unit and Gerontology & Geriatrics Research Laboratories, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy. alberto.pilotto@libero.it

Country: Switzerland

AGENCY:

GRANT:

ACRONYM:

MEDLINETA: Dig Dis

REFSOURCE:

DATABASENAME:

ACCESSION NUMBER:

Number Hits: 0

Usefulness of the comprehensive geriatric assessment in older patients with upper gastrointestinal bleeding: a two-year follow-up study Related Publications

• A genetic-demographic approach reveals male-specific association between survival and tumor necrosis factor (a/g)-308 polymorphism.
• A novel mitochondrial DNA-like sequence insertion polymorphism in Intron I of the FOXO1A gene.
• Analysis of transcription factor interactions in osteoblasts using competitive chromatin immunoprecipitation.
• Back to the future: the ribosome as an antibiotic target.
• Bone morphogenetic proteins, extracellular matrix, and mitogen-activated protein kinase signaling pathways are required for osteoblast-specific gene expression and differentiation in MC3T3-E1 cells.
• Chapter 27: Research needs following initial licensure of virus-like particle HPV vaccines.
• Common evolutionary origin of the immune and neuroendocrine systems: from morphological and functional evidence to in silico approaches.
• Critical role of the extracellular signal-regulated kinase-MAPK pathway in osteoblast differentiation and skeletal development.
• Daunorubicin and daunorubicinol tissue concentrations in gastric cancer patients after local administration of a liposomal preparation.
• Different types of cell death in organismal aging and longevity: state of the art and possible systems biology approach.
• Erythrocyte plasma membranes obtained from centenarians show different functional properties.
• Healing Cranial Defects with AdRunx2-transduced Marrow Stromal Cells.
• Human longevity within an evolutionary perspective: The peculiar paradigm of a post-reproductive genetics.
• Human papillomavirus infection in women with and without cervical cancer in Warsaw, Poland.
• Human papillomavirus types among women infected with HIV: a meta-analysis.
• Immunoproteasome in Macaca fascicularis: No Age-Dependent Modification of Abundance and Activity in the Brain and Insight into an in silico Structural Model.
• In vitro and in vivo synergistic interactions between the Runx2/Cbfa1 transcription factor and bone morphogenetic protein-2 in stimulating osteoblast differentiation.
• Incidence of primary liver cancer in Italy between 1988 and 2002: An age-period-cohort analysis.
• Inflammaging as a major characteristic of old people: can it be prevented or cured?
• Long-term immune-endocrine effects of bereavement: relationships with anxiety levels and mood.
• Members of the human papillomavirus type 18 family (alpha-7 species) share a common association with adenocarcinoma of the cervix.
• New molecular targets and novel anticancer treatments: emerging trends in neuro-oncology.
• Paraoxonase 1: genetics and activities during aging.
• Plasma concentrations of interleukin-1-beta, interleukin-6 and tumor necrosis factor-alpha, and of their soluble receptors and receptor antagonist in anorexia nervosa.
• Prevalence of hepatitis B and C serological markers among first-time blood donors in Brazil: a multi-center serosurvey.
• Risk of cancer following immunosuppression in organ transplant recipients and in HIV-positive individuals in southern Europe.
• Serologic response to oncogenic human papillomavirus types in male and female university students in Busan, South Korea.
• The IARC commitment to cancer prevention: the example of papillomavirus and cervical cancer.
• Use of a stringent dimerizer-regulated gene expression system for controlled BMP2 delivery.
• Usefulness of the comprehensive geriatric assessment in older patients with upper gastrointestinal bleeding: a two-year follow-up study.