Mortality rate and risk factors for gastrointestinal bleeding in elderly patients

Lenti, Marco Vincenzo; Pasina, Luca; Cococcia, Sara; Cortesi, Laura; Miceli, Emanuela; Dominioni, C. Caccia; Pisati, M.; Mengoli, Caterina; Perticone, Francesco; Nobili, Alessandro; Corazza, Gino Roberto; Investigators, Reposi

doi:10.1016/j.ejim.2018.11.003

Cited by 60 publications

(57 citation statements)

References 39 publications

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“…Median age in our cohort was 75 years, confirming previously published data showing that UGIB predominantly afflicts elderly patients with comorbidities in a hospital setting [25] .…”

Section: Discussionsupporting

confidence: 90%

Upper gastrointestinal bleeding in COVID-19 inpatients: Incidence and management in a multicenter experience from Northern Italy

Mauro

Grazia

Lenti

et al. 2021

Clinics and Research in Hepatology and Gastroenterology

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Highlights UGIB has a prevalence of 0.47% in non-ICU COVID-19 patients and peptic disease is the most common finding. Half of patients were managed conservatively or with delayed endoscopy. This is the first report that evaluates incidence of UGIB in COVID-19 patients. Conservative management and delayed endoscopy could be a successful option in patients with significant respiratory impairment.

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“…Median age in our cohort was 75 years, confirming previously published data showing that UGIB predominantly afflicts elderly patients with comorbidities in a hospital setting [25] .…”

Section: Discussionsupporting

confidence: 90%

Upper gastrointestinal bleeding in COVID-19 inpatients: Incidence and management in a multicenter experience from Northern Italy

Mauro

Grazia

Lenti

et al. 2021

Clinics and Research in Hepatology and Gastroenterology

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“…In the present study, frail subjects were older, with a worse renal function, lower hemoglobin level and higher number of comorbidities. Importantly, in our multivariate model, we also introduced CIRS-CI, a risk adjustment tool useful for assessing patients' comorbidities and prognoses [38,39], not included in the CFS, which came out as significantly associated with frailty. Regarding the parameters related to cardiac function, frail HF patients presented a worse NYHA functional class, worse LVEF and higher NT-proBNP levels.…”

Section: Discussionmentioning

confidence: 99%

Impact of Galectin-3 Circulating Levels on Frailty in Elderly Patients with Systolic Heart Failure

Komici

Gnemmi

Bencivenga

et al. 2020

JCM

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Background: Heart Failure (HF), a leading cause of morbidity and mortality, represents a relevant trigger for the development of frailty in the elderly. Inflammation has been reported to play an important role in HF and frailty pathophysiology. Galectin-3 (Gal-3), whose levels increase with aging, exerts a relevant activity in the processes of cardiac inflammation and fibrosis. The aim of the present study was to investigate the potential of Galectin-3 to serve as a biomarker of frailty in HF patients. Methods: 128 consecutive patients aged 65 and older with the diagnosis of systolic HF underwent a frailty assessment and blood sample collection for serum Gal-3 detection. A multivariable regression analysis and decision curve analysis (DCA) were used to identify significant predictors of frailty. Results: Frailty was present in 42.2% of patients. Age: Odds Ratio (OR) = 3.29; 95% Confidence Interval CI (CI) = 1.03–10.55, Cumulative Illness Rating Scale Comorbidity Index (CIRS-CI): OR = 1.85; 95% CI = 1.03–3.32, C-Reactive phase Protein (CRP) OR = 3.73; 95% CI = 1.24–11.22, N-terminal-pro-Brain Natriuretic Peptide (NT-proBNP): OR = 2.39; 95% CI = 1.21–4.72 and Gal-3: OR = 5.64; 95% CI = 1.97–16.22 resulted in being significantly and independently associated with frailty. The DCA demonstrated that the addition of Gal-3 in the prognostic model resulted in an improved clinical ‘net’ benefit. Conclusions: Circulating levels of Gal-3 are independently associated with frailty in elderly patients with systolic HF.

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“…Previously, some studies had investigated that male and previous history of diabetes were independent risk factors for non-varicose upper gastrointestinal bleeding in patients taking aspirin or other non-steroidal anti-inflammatory drugs [7][8][9][10]. It had been demonstrated that multiple comorbidities (such as hypertension, diabetes) were associated with the occurrence of GIB in elderly inpatients, rather than only a single organ failure or the combined use of multiple drugs [11]. Mora et al [12] confirmed that hematocrit is a risk factor for GIB and a predictor of poor prognosis.…”

Section: Discussionmentioning

confidence: 99%

Gastrointestinal Bleeding in Patients Admitted to Cardiology: risk factors and a new risk score

Zhang

Liu

Wang

et al. 2020

Preprint

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Background: Although the early use of a risk stratification score in gastrointestinal bleeding(GIB) is recommended, there has been no risk score for GIB in patients admitted to cardiology so far.Objective:To describe the risk factors of GIB and develop a new risk score model in patients admitted to cardiology. Methods: A total of 633 inpatients with GIB from January 2014 to December 2018 were recruited, 4,231 inpatients with non-GIB recruited as the control group. Multivariate logistic regression was used to describe the risk factors of GIB,A new risk score model was developed in the derivation cohort. Accuracy to predict GIB was assessed by the area under the receiver operating characteristic (AUROC) curve in the validation cohort.Results: Male, coronary heart disease, hypertension, stroke, systolic blood pressure, hematocrit, plasma albumin and alanine aminotransferase(ALT) were associated with GIB . The model had a high predictive accuracy (AUROC 0.816; 95%CI, 0.792-0.839), which was supported by the validation cohort (AUROC 0.841; 95% CI, 0.807~0.874). Besides,the prediction of the model better than HAS-BLED score(AUROC 0.557; 95%CI, 0.513~0.602) and CRUSADE score(AUROC 0.791; 95%CI, 0.757~0.825), respectively. Among the inpatients with a score 0-3, 4-7, and ≥8 points, the incidence of GIB, the proportion of inpatients requiring suspended red blood cells transfusion, length of stay and in-hospital mortality all increased gradually(P< 0.001). Conclusions: Male, coronary heart disease, hypertension, stroke, systolic blood pressure, hematocrit, plasma albumin and ALT are associated with GIB. The new risk score model is an accurate risk score that predicts GIB in patients admitted to cardiology.

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Mortality rate and risk factors for gastrointestinal bleeding in elderly patients

Cited by 60 publications

References 39 publications

Upper gastrointestinal bleeding in COVID-19 inpatients: Incidence and management in a multicenter experience from Northern Italy

Upper gastrointestinal bleeding in COVID-19 inpatients: Incidence and management in a multicenter experience from Northern Italy

Impact of Galectin-3 Circulating Levels on Frailty in Elderly Patients with Systolic Heart Failure

Gastrointestinal Bleeding in Patients Admitted to Cardiology: risk factors and a new risk score

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