Low-dose Aspirin and Comorbidities are Significantly Related to Bleeding Peptic Ulcers in Elderly Patients Compared with Nonelderly Patients in Japan
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- Higuchi Toru
- Departments of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, Japan
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- Iwakiri Ryuichi
- Departments of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, Japan
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- Hara Megumi
- Department of Preventive Medicine, Saga Medical School, Japan
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- Shimoda Ryo
- Departments of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, Japan
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- Sakata Yasuhisa
- Departments of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, Japan
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- Nakayama Atsushi
- Departments of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, Japan
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- Nio Kenta
- Departments of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, Japan
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- Yamaguchi Shunsuke
- Departments of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, Japan
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- Yamaguchi Daisuke
- Departments of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, Japan
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- Watanabe Akira
- Departments of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, Japan
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- Akutagawa Takashi
- Departments of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, Japan
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- Sakata Hiroyuki
- Departments of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, Japan
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- Fujimoto Kazuma
- Departments of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, Japan
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Objective The present study was conducted using data accumulated from our earlier study of bleeding peptic ulcers, focusing on elderly patients.<br> Methods A total of 461 patients with bleeding peptic ulcers underwent emergency endoscopy at Saga Medical School Hospital between 1999 and 2011. Risk factors for bleeding peptic ulcers were compared between two groups: an elderly group (≥65 years old) and a nonelderly group (<65 years old). The relationship between drug use and age was examined using multiple logistic regression models. In the elderly group, the factors were compared between Period I (1999-2005) and Period II (2006-2011).<br> Results The proportion of men and the incidence of Helicobacter pylori infection were lower in the elderly group than in the nonelderly group. The use of low-dose aspirin, antithrombotic drugs and corticosteroids, but not nonsteroidal anti-inflammatory drugs, was higher in the elderly group. A multiple logistic regression analysis of prescribed medications indicated that low-dose aspirin was more frequently used in the elderly group. The rate of comorbidities was higher and the hemoglobin levels were lower in the elderly group. The rates of rebleeding within one week and death within one month did not differ in the elderly group. Compared with that observed in Period I, the incidence of Helicobacter pylori infection was decreased and the rate of comorbidities was increased in Period II.<br> Conclusion This study indicates that factors related to bleeding peptic ulcers in elderly patients have shifted from Helicobacter pylori infection to comorbidities associated with low-dose aspirin, suggesting a close relationship between low-dose aspirin therapy and comorbidities in elderly patients with peptic ulcers.<br>
収録刊行物
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- Internal Medicine
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Internal Medicine 53 (5), 367-373, 2014
一般社団法人 日本内科学会