Geriatrics Unit, Azienda ULSS 16 Padova, S. Antonio Hospital, Padova I-35127, Italy.
World J Gastroenterol. 2011 Jul 7;17(25):3020-6. doi: 10.3748/wjg.v17.i25.3020.
To evaluate the prevalence of upper gastrointestinal symptoms and their association with clinical and functional characteristics in elderly outpatients.
The study involved 3238 outpatients ≥ 60 years consecutively enrolled by 107 general practitioners. Information on social, behavioral and demographic characteristics, function in the activities of daily living (ADL), co-morbidities and drug use were collected by a structured interview. Upper gastrointestinal symptom data were collected by the 15-items upper gastro-intestinal symptom questionnaire for the elderly, a validated diagnostic tool which includes the following five symptom clusters: (1) abdominal pain syndrome; (2) reflux syndrome; (3) indigestion syndrome; (4) bleeding; and (5) non-specific symptoms. Presence and severity of gastrointestinal symptoms were analyzed through a logistic regression model.
3100 subjects were included in the final analysis. The overall prevalence of upper gastrointestinal symptoms was 43.0%, i.e. cluster (1) 13.9%, (2) 21.9%, (3) 30.2%, (4) 1.2%, and (5) 4.5%. Upper gastrointestinal symptoms were more frequently reported by females (P < 0.0001), with high number of co-morbidities (P < 0.0001), who were taking higher number of drugs (P < 0.0001) and needed assistance in the ADL. Logistic regression analysis demonstrated that female sex (OR = 1.39, 95% CI: 1.17-1.64), disability in the ADL (OR = 1.47, 95% CI: 1.12-1.93), smoking habit (OR = 1.29, 95% CI: 1.00-1.65), and body mass index (OR = 1.06, 95% CI: 1.04-1.08), as well as the presence of upper (OR = 3.01, 95% CI: 2.52-3.60) and lower gastroenterological diseases (OR = 2.25, 95%CI: 1.70-2.97), psychiatric (OR = 1.60, 95% CI: 1.28-2.01) and respiratory diseases (OR = 1.25, 95% CI: 1.01-1.54) were significantly associated with the presence of upper gastrointestinal symptoms.
Functional and clinical characteristics are associated with upper gastrointestinal symptoms. A multidimensional comprehensive evaluation may be useful when approaching upper gastrointestinal symptoms in older subjects.
评估老年门诊患者上消化道症状的流行情况及其与临床和功能特征的关系。
本研究纳入了由 107 名全科医生连续招募的 3238 名≥60 岁的门诊患者。通过结构化访谈收集社会、行为和人口统计学特征、日常生活活动（ADL）功能、合并症和药物使用信息。使用经过验证的老年上消化道症状问卷（15 项）收集上消化道症状数据，该问卷包括以下五个症状群：（1）腹痛综合征；（2）反流综合征；（3）消化不良综合征；（4）出血；和（5）非特异性症状。通过逻辑回归模型分析胃肠道症状的存在和严重程度。
最终有 3100 名患者纳入了最终分析。上消化道症状的总体患病率为 43.0%，即（1）腹痛综合征 13.9%，（2）反流综合征 21.9%，（3）消化不良综合征 30.2%，（4）出血 1.2%，（5）非特异性症状 4.5%。女性（P < 0.0001）、合并症较多（P < 0.0001）、服用药物较多（P < 0.0001）且 ADL 需要帮助的患者更常报告上消化道症状。逻辑回归分析表明，女性（OR = 1.39，95%CI：1.17-1.64）、ADL 残疾（OR = 1.47，95%CI：1.12-1.93）、吸烟习惯（OR = 1.29，95%CI：1.00-1.65）和体质指数（OR = 1.06，95%CI：1.04-1.08），以及上（OR = 3.01，95%CI：2.52-3.60）和下消化道疾病（OR = 2.25，95%CI：1.70-2.97）、精神疾病（OR = 1.60，95%CI：1.28-2.01）和呼吸系统疾病（OR = 1.25，95%CI：1.01-1.54）的存在与上消化道症状的存在显著相关。
功能和临床特征与上消化道症状相关。对老年患者的上消化道症状进行多维综合评估可能是有用的。
