Geriatric Department, Faculty of Medicine, Shaare-Zedek Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel.
Faculty of Medicine, Shaare-Zedek Medical Center, Digestive Diseases Institute, Hebrew University of Jerusalem, Jerusalem, Israel.
Age Ageing. 2021 Sep 11;50(5):1840-1844. doi: 10.1093/ageing/afab129.
invasive gastrointestinal (GI) procedures are increasingly performed on much older patients but data regarding oesophagogastroduodenoscopy (OGD) in this population are limited. We compared the indications, safety and benefits of OGD for nonagenarians compared to octogenarians.
an observational retrospective review of patients who underwent OGD between 2013 and 2018 at a gastroenterology institute in one large hospital. Patients aged 90 and above 'nonagenarians' were compared to those aged 80-89 'octogenarians'.
472 patients (231 nonagenarians and 241 octogenarians), median age of 91 for nonagenarians (201 aged 90-94, 30 aged 95 and older) and 82 (174 aged 80-84, 67 aged 85-89) for octogenarians. GI bleeding was a more common and dyspepsia, a less common, indication for nonagenarians compared to octogenarians (55 and 7%, versus 43 and 18%). Significant findings and need for endoscopic treatments were both more commonly found in nonagenarians compared to octogenarians (25 and 24% versus 15 and 8%, respectively). General anaesthesia was more commonly given to nonagenarians (35 versus 10%). Immediate complications and 30-day mortality rate were similar between the groups: (2.6% of nonagenarians versus 1.6% of octogenarians). Of 30 patients aged 95 and older, 13% had late adverse events, compared to 1% of the overall cohort.
OGD appears safe in nonagenarians. Pathological findings and endoscopic interventions are more common. Decisions regarding OGD should not be based on age alone.
越来越多的高龄患者接受了侵袭性胃肠（GI）检查，但针对该人群行上消化道内镜检查（OGD）的数据有限。我们比较了 90 岁以上患者（非 90 岁组）和 80-89 岁患者（80 岁组）行 OGD 的适应证、安全性和获益。
回顾性观察性研究分析了 2013 年至 2018 年期间在一家大型医院的胃肠病学研究所接受 OGD 的患者。将年龄 90 岁及以上的患者（非 90 岁组）与年龄 80-89 岁的患者（80 岁组）进行比较。
共纳入 472 例患者（231 例非 90 岁组，241 例 80 岁组），非 90 岁组患者的中位年龄为 91 岁（201 例年龄为 90-94 岁，30 例年龄≥95 岁），80 岁组患者的中位年龄为 82 岁（174 例年龄为 80-84 岁，67 例年龄为 85-89 岁）。非 90 岁组与 80 岁组相比，OGD 的主要适应证为 GI 出血（55%和 7%），而非消化不良（43%和 18%）。非 90 岁组患者的内镜下发现和需要内镜治疗的情况更为常见（25%和 24%比 15%和 8%）。非 90 岁组更常使用全身麻醉（35%比 10%）。两组的即刻并发症和 30 天死亡率相似（非 90 岁组 2.6%，80 岁组 1.6%）。30 例年龄≥95 岁的患者中，13%发生迟发性不良事件，而总体队列中为 1%。
OGD 在 90 岁以上患者中是安全的。该组患者的病理性发现和内镜干预更为常见。进行 OGD 检查的决策不应仅基于年龄。
