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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
PubMed

Insights

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.
Abstract

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