Short-term mortality after perforated or bleeding peptic ulcer among elderly patients: a population-based cohort study.

https://arctichealth.org/en/permalink/ahliterature78037
Source
BMC Geriatr. 2007;7:8
Publication Type
Article
Date
2007
Author
Christensen Steffen
Riis Anders
Nørgaard Mette
Sørensen Henrik T
Thomsen Reimar W
Author Affiliation
Department of Clinical Epidemiology, Aalborg and Aarhus Hospital, Aarhus University Hospital, Denmark. sc@dce.au.dk
Source
BMC Geriatr. 2007;7:8
Date
2007
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Cohort Studies
Denmark - epidemiology
Female
Humans
Male
Peptic Ulcer Hemorrhage - complications - mortality
Peptic Ulcer Perforation - complications - mortality
Abstract
BACKGROUND: Mortality after perforated and bleeding peptic ulcer increases with age. Limited data exist on how the higher burden of comorbidity among elderly patients affects this association. We aimed to examine the association of age with short-term mortality after perforated and bleeding peptic ulcer and to determine the impact of comorbidity on this association. METHODS: In this population-based cohort study in three Danish counties between 1991 and 2003 we identified two cohorts of patients: those hospitalized with a first-time discharge diagnosis of perforated peptic ulcer and those with bleeding peptic ulcer. The diagnoses were ascertained from hospital discharge registries and mortality through the Danish Civil Registration System. Information on comorbidity and use of ulcer-related drugs was obtained through administrative medical databases. We computed age-, gender- and comorbidity-standardized 30-day mortality rates and used Cox's regression to estimate adjusted 30-day mortality rate ratios (MRR) for elderly compared with younger patients. RESULTS: Among 2,061 patients with perforated peptic ulcer, 743 (36%) were 65-79 years old and 513 patients (25%) were aged 80+ years. Standardized 30-day mortality was 8.9% among patients younger than 65 years rising to 44.6% among patients aged 80+ years, corresponding to an adjusted MRR of 5.3 (95% CI: 4.0-7.0). Among 7,232 patients with bleeding peptic ulcer 2,372 (33%) were aged 80+ years. Standardized 30-day mortality among patients younger than 65 was 4.3% compared with 16.9% among patients aged 80+ years, corresponding to an adjusted MRR of 3.7 (95% CI: 2.9-4.7). Analyses stratified by comorbidity consistently showed high MRRs among elderly patients, regardless of comorbidity level. CONCLUSION: Ageing is a strong predictor for a poor outcome after perforated and bleeding peptic ulcer independently of comorbidity.
PubMed ID
17439661 View in PubMed
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