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Titolo:
Risk factors for hospitalized gastrointestinal bleeding among older persons
Autore:
Kaplan, RC; Heckbert, SR; Koepsell, TD; Furberg, CD; Polak, JF; Schoen, RE; Psaty, BM;
Indirizzi:
Albert Einstein Coll Med, Dept Epidemiol & Social Med, Bronx, NY 10461 USAAlbert Einstein Coll Med Bronx NY USA 10461 cial Med, Bronx, NY 10461 USA Univ Washington, Cardiovasc Hlth Res Unit, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 Hlth Res Unit, Seattle, WA 98195 USA Univ Washington, Dept Epidemiol, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 ept Epidemiol, Seattle, WA 98195 USA Univ Washington, Dept Med, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 ton, Dept Med, Seattle, WA 98195 USA Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 ept Hlth Serv, Seattle, WA 98195 USA Wake Forest Univ, Sch Med, Dept Publ Hlth Sci, Winston Salem, NC 27109 USAWake Forest Univ Winston Salem NC USA 27109 , Winston Salem, NC 27109 USA Harvard Univ, Brigham & Womens Hosp, Dept Radiol, Cambridge, MA 02138 USA Harvard Univ Cambridge MA USA 02138 Dept Radiol, Cambridge, MA 02138 USA Univ Pittsburgh, Div Gastroenterol & Hepatol, Pittsburgh, PA 15260 USA Univ Pittsburgh Pittsburgh PA USA 15260 Hepatol, Pittsburgh, PA 15260 USA Univ Pittsburgh, Dept Epidemiol, Pittsburgh, PA 15260 USA Univ PittsburghPittsburgh PA USA 15260 idemiol, Pittsburgh, PA 15260 USA
Titolo Testata:
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY
fascicolo: 2, volume: 49, anno: 2001,
pagine: 126 - 133
SICI:
0002-8614(200102)49:2<126:RFFHGB>2.0.ZU;2-A
Fonte:
ISI
Lingua:
ENG
Soggetto:
CARDIOVASCULAR-DISEASE; HELICOBACTER-PYLORI; PHYSICAL-ACTIVITY; PEPTIC-ULCER; HEMORRHAGE; EPIDEMIOLOGY; MORTALITY; SMOKING; HEALTH; DRUGS;
Keywords:
gastrointestinal bleeding; risk factors; nonsteroidal anti-inflammatory drugs; gastrointestinal ischemia;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Social & Behavioral Sciences
Clinical Medicine
Citazioni:
29
Recensione:
Indirizzi per estratti:
Indirizzo: Kaplan, RC Albert Einstein Coll Med, Dept Epidemiol & Social Med, Belfer Bldg,Room 1308C, Bronx, NY 10461 USA Albert Einstein Coll Med Belfer Bldg,Room 1308C Bronx NY USA 10461
Citazione:
R.C. Kaplan et al., "Risk factors for hospitalized gastrointestinal bleeding among older persons", J AM GER SO, 49(2), 2001, pp. 126-133

Abstract

OBJECTIVES: We sought to estimate the incidence of hospitalization for upper and lower gastrointestinal bleeding among older persons and to identify independent risk factors. DESIGN: Prospective cohort study. SETTING: The Cardiovascular Health Study (CHS). PARTICIPANTS: 5888 noninstitutionalized men and women age 65 years or older in four U.S. communities enrolled in the CHS. MEASUREMENTS: Gastrointestinal bleeding events during the period 1989 through 2998 were identified using hospital discharge diagnosis codes and confirmed by medical records review. Risk-factor information was collected in a standardized fashion at study baseline and annually during follow-up. RESULTS: Among CHS participants (mean baseline age 73.3 years, 42% male), the incidence of hospitalized gastrointestinal bleeding was 6.8/1000 person-years. In multivariate analyses, advanced age, male sex, unmarried status,cardiovascular disease, difficulty with daily activities, use of multiple medications, and use of oral anticoagulants were independent risk factors. Compared with nonsmokers, subjects who smoked more than half a pack per dayhad a multivariate-adjusted hazard ratio (HR) of 2.14 (95% confidence interval [CI] = 1.22-3.75) for upper gastrointestinal bleeding and a multivariare-adjusted HR of 0.21 (95% CI = 0.03-1.54) for lower gastrointestinal bleeding. Aspirin users did not have an elevated risk of upper gastrointestinalbleeding (HR = 0.76, 95% CI = 0.52-1.11), and users of other nonsteroidal anti-inflammatory drugs had a HR of 1.54 (95% CI = 0.99-2.36). Low ankle-arm systolic blood pressure index was associated with higher risk of gastrointestinal bleeding among subjects with clinical cardiovascular disease but not among those without clinical cardiovascular disease. CONCLUSION: This study identifies risk factors for gastrointestinal bleeding, such as disability, that may be amenable to modification. The findings will help clinicians to identify older persons who are at high risk for gastrointestinal bleeding.

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Documento generato il 30/11/20 alle ore 03:29:36