Gastroduodenal ulcer bleeding in elderly patients on low dose aspirin therapy

作     者：Koh Fukushi Keiichi Tominaga Kazunori Nagashima Akira Kanamori Naoya Izawa Mimari Kanazawa Takako Sasai Hideyuki Hiraishi 

作者机构：Department of Gastroenterology Dokkyo Medical University Department of General Internal Medicine 2 Kawasaki Medical School General Medical Center 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2018年第24卷第34期

页      面：3908-3918页

核心收录：

学科分类：1002[医学-临床医学] 10[医学] 

主　　题：Hemorrhagic gastroduodenal ulcer Low-dose aspirin Antithrombotic drugs Elderly patients Proton pump inhibitor 

摘      要：AIM To determine the clinical characteristics of elderly patients of hemorrhagic gastroduodenal ulcer on low-dose aspirin(LDA)therapy.METHODS A total of 1105 patients with hemorrhagic gastroduodenal ulcer treated in our hospital between January 2000 and March 2016 were grouped by age and drugs used,and these groups were compared in several factors.These groups were compared in terms of length of hospital stay,presence/absence of hemoglobin(Hb)decrease,presence/absence of blood transfusion,Forrest Ⅰ,percentage of Helicobacter pylori infection,presence/absence of underlying disease,and percentage of severe cases.RESULTS The percentage of blood transfusion(62.6%vs 47.7%,P0.001),Hb decrease(53.8% vs 40.8%,P0.001),and the length of hospital stay(23.5 d vs 16.7 d,P0.001)were significantly greater in those on drug therapy.The percentage of blood transfusion(65.3%vs 47.8%,P0.001),Hb decrease(54.2%vs 42.1%,P0.001),and length of hospital stay(23.3 d vs 17.5 d,P0.001)were significantly greater in the elderly.In comparison with the LDA monotherapy group,the percentage of severe cases was significantly higher in the LDA combination therapy group when elderly patients were concerned(16.1%vs34.0%,P=0.030).Meanwhile,among those on LDA monotherapy,there was no significant difference between elderly and non-elderly(16.1%vs 16.0%,P=0.985).CONCLUSION A combination of LDA with antithrombotic drugs or nonsteroidal anti-inflammatory drugs(NSAIDs)contributes to aggravation.And advanced age is not an aggravating factor when LDA monotherapy is used.