ABSTRACT
Objectives:
Upper gastrointestinal system (GIS) endoscopy is an important diagnostic and therapeutic tool in geriatric patients, similarly to other age groups. Here we aimed to present the indications, endoscopic and pathologic findings and also endoscopy related complications of upper endoscopic procedures in our geriatric population.
Materials and Methods:
This study was designed as a retrospective study. Patients over 65 years old who had either diagnostic and/or therapeutic upper gastrointestinal system endoscopy between 1 January 2017-1 January 2018 in Keçiören Training and Research Hospital were enrolled into the study. Based on their age, patients were divided into two subgroups: group 1: patients aged between 65-80 years old and group 2: patients aged over 80 years old.
Results:
Overall 1154 patients (median age 74.2±6.38, male/female: 44.7/55.3) were enrolled into the study. Tissue biopsy was performed in 1018 patients. The most frequent upper GIS endoscopy indication was dyspepsia (86.3%). Gastritis (81.5%) and lower esophageal sphincter (LES) relaxation (34%) were the most frequent endoscopic findings. Nevertheless the frequency of gastric cancer and peptic ulcer were 1.4% and 1.1%, respectively. The frequency of H. pylori in our patients was 41.7%. Between two groups, endoscopy indications, endoscopic findings and frequency of H. pylori were not significantly different. We did not observe any complication and upper GIS endoscopy associated mortality in our patients.
Conclusion:
Upper GIS endoscopy can be perform in terms of diagnostic or therapeutic with safely in geriatric patients even if patient is extremely elder. Age, alone must not a router to decide upper GIS endoscopy in geriatric patient.
Keywords:
Endoscopy, Geriatric Patient, Peptic Ulcer
References
1Franceschi M, Di Mario F, Leandro G, et al. Acid-related disorders in the elderly. Best Pract Res Clin Gastroenterol. 2009;23:839-848.
2Jim MA, Pinheiro PS, Carreira H, et al. Stomach cancer survival in the United States by race and stage (2001-2009): Findings from the CONCORD-2 study. Cancer. 2017;24:4994-5013.
3Wongrakpanich S, Wongrakpanich A, Melhado K, et al. A Comprehensive Review of Non-Steroidal Anti-Inflammatory Drug Use in The Elderly. Aging Dis. 2018;9:143-150.
4Kandemir A, Arabul M, Çelik M, ve ark. Yaşlı Hastalarda Gastrointestinal Endoskopik İncelemerin Değerlendirilmesi. Turkish Journal of Geriatrics 2013;16:43-47.
5Durazzo M, Campion D, Fagoonee S, Pellicano R. Gastrointestinal tract disorders in the elderly. Minerva Med. 2017;108:575-591.
6Clarke GA, Jacobson BC, Hammett RJ, et al. The indications, utilization and safety of gastrointestinal endoscopy in an extremely elderly patients cohort. Endoscopy. 2001;33:580-584
7Seinelä L, Ahvenainen J, Rönneikkö J, et al. Reasons for and outcome of upper gastrointestinal endoscopy in patients aged 85 years or more: retrospective study. BMJ. 1998;317:575-580.
8Lee TC, Huang SP, Yang JY, et al. Age is not a discriminating factor for outcomes of therapeutic upper gastrointestinal endoscopy. Hepatogastroenterology. 2007;54:1319-1322.
9Kawaguchi K, Kurumi H, Takeda Y, et al. Management for non-variceal bleeding in elderly patients: the gastrointestinal bleeding in elderly patients: the experience of a tertiary university hospital. Ann Transl Med. 2017;5:181.
10Van Kouwen MC, Drenth JP, Verhoeven HM, et al. Upper gastrointestinal endoscopy in patients aged 85 years or more. Results of a feasibility study in a district general hospitalArch Gerontol Geriatr. 2003;37:45-50.
11Archimandritis A, Spiliadis C, Tzivras M, et al. Gastric epithelial polyps: a retrospective endoscopic study of 12974 symptomatic patients. Ital J Gastroenterol. 1996;28:387-390
12Jalving M, Koornstra JJ, Wesseling J, et al. Increased risk of fundic gland polyps during long-term proton pump inhibitor therapy. Aliment Pharmacol Ther. Aliment Pharmacol Ther. 2006;24:1341-1348.
13Pilotto A. Aging and the gastrointestinal tract. Ital J Gastroenterol Hepatol 1999;31:137-153.
14Pilotto A, Franceschi M, Valerio G, et al. Helicobacter pylori infection in elderly patients with peptic ulcer. Age Ageing. 1999;28:412-414.
15Nagini S. Carcinoma of the stomach: A review of epidemiology, pathogenesis, molecular genetics and chemoprevention. World J Gastrointest Oncol 2012;4:156-169.
16Daniel VT, Wiseman JT, Flahive J,et al. Predictors of mortality in the elderly after open repair for perforated peptic ulcer disease J Surg Res. 2017l;215:108-113.
