Upper endoscopy in elderly patients: a multicentre study.

Abstract

Background: Both macroscopic and histological lesions are frequently detected at upper endoscopy in elderly patients. We assessed the prevalence of the main endoscopic and histological alteration in aged patients who underwent upper endoscopy. Methods: In this cross-sectional study, clinical, endoscopic, and histological features of consecutive elderly patients referred for upper endoscopy in clinical practice were retrieved. Data were analysed at both univariate and multivariate analyses. Results: A total of 1,336 (M/F: 595/741; Mean age: 74.1; range: 65-102) underwent upper endoscopy during one month in the 28 participating centres. At endoscopy, at least one macroscopic lesion was present in overall 420 (31.4%) patients. Erosive gastritis (13.3%) and erosive oesophagitis (9.8%) were the most prevalent lesions, whilst Barrett’s oesophagus, gastric ulcer, duodenal ulcer and erosive duodenitis were observed in 1.8%, 2%, 1.4%, and 3.1% patients, respectively. Nine (0.6%) cases of oesophageal, 25 (1.8%) gastric, and 2 (0.1%) duodenal neoplasia were detected. At histology, H. pylori infection was diagnosed in 99 (15.9%) patients, and extensive (antral plus corporal) precancerous lesions on gastric mucosa were detected in 80 patients (14.5%). Endoscopic lesions were more frequent in males, in patients who underwent first endoscopy, and in those with alarm symptoms, whilst were reduced in patients receiving PPI therapy. At multivariate analysis, no independent predictor was found. Conclusions: Our data found that frequency of erosive and neoplastic lesions remained high in elderly patients, whilst the prevalence of both H. pylori infection and peptic ulcer was decreased.