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Risk factors for hospitalized gastrointestinal bleeding among older persons. Cardiovascular Health Study
R C Kaplan1, S R Heckbert, T D Koepsell
1Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
Journal of the American Geriatrics Society
|February 24, 2001
Summary
This study identified key risk factors for gastrointestinal bleeding in older adults, including advanced age, cardiovascular disease, and medication use. These findings help clinicians identify high-risk individuals for targeted prevention strategies.
Area of Science:
- Gerontology
- Gastroenterology
- Epidemiology
Background:
- Gastrointestinal (GI) bleeding is a significant concern in older populations.
- Estimating the incidence and identifying risk factors for GI bleeding in the elderly is crucial for public health.
- Previous research has not comprehensively addressed these factors in a large, prospective cohort of older adults.
Purpose of the Study:
- To estimate the incidence of hospitalization for upper and lower gastrointestinal bleeding among individuals aged 65 years and older.
- To identify independent risk factors associated with gastrointestinal bleeding in this demographic.
Main Methods:
- Prospective cohort study design utilizing data from the Cardiovascular Health Study (CHS).
- Inclusion of 5,888 noninstitutionalized men and women aged 65+ from four U.S. communities.
- Identification of GI bleeding events via hospital discharge codes, confirmed by medical records review, with risk factor data collected at baseline and annually.
Main Results:
- The incidence of hospitalized gastrointestinal bleeding was 6.8 per 1,000 person-years.
- Independent risk factors identified include advanced age, male sex, unmarried status, cardiovascular disease, functional disability, polypharmacy, and oral anticoagulant use.
- Heavy smoking (>0.5 packs/day) increased upper GI bleeding risk (HR=2.14), while aspirin use did not elevate upper GI bleeding risk (HR=0.76).
Conclusions:
- Disability and other identified factors represent potentially modifiable risks for gastrointestinal bleeding in older adults.
- The study provides valuable insights for clinicians to better identify and manage older patients at high risk for GI bleeding.
- Findings underscore the importance of considering multiple comorbidities and lifestyle factors in assessing GI bleeding risk in the elderly.