[Unexplained weight loss in the elderly: role of gastric fibroscopy, study of a cohort of 77 patients with a 13-month follow-up].
OBJECTIVE
In case of unexplained weight loss, chest X-ray, abdominal ultrasonography and gastroscopy are usually recommended. However, gastroscopy is not usually performed in elderly patients.


METHODS
We evaluated 77 patients (mean age: 80 +/- 8 years) hospitalized in our geriatric unit between January 1995 and May 1997 for unexplained weight loss. All patients underwent chest X-ray, abdominal ultrasonography and gastroscopy.


RESULTS
These investigations led to diagnosis in respectively 17, 15 and 46 patients. The etiology of weight loss was unique in 47 patients, while in 30 other patients at least two or three causes could be described. Gastroscopy appeared to be the most useful test, as it allowed description of eight cases of cancer, 29 cases of peptic ulcer, two cases of candidosis, and one case of actinomycosis in patients who did not present any clinical sign.


CONCLUSIONS
Sixty-five patients were followed-up for a mean period of 13 +/- 21 month; 33 patients died. The condition of 23 patients improved either slightly or definitely. Simple investigations led to diagnosis in 95% of the cases. However, 42% of the patients died within 3 months. Gastroscopy appears to be the most valuable test, leading to diagnosis in more than half of the cases. With adapted treatment, the condition of 75% of the patients with gastro-intestinal lesions improved.
Fauchais
A L
AL
Service de médecine interne et gériatrie, hôpital gériatrique Les Bateliers, CHRU, rue des Bateliers, 59800 Lille, France.
Puisieux
F
F
Bulckaen
H
H
Salomez-Garnier
F
F
Dewailly
P
P
D000005:Abdomen / Q000000981:diagnostic imaging; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D005773:Gastroscopy / Q000379:methods*; D005853:Geriatrics; D006801:Humans; D008297:Male; D011379:Prognosis; D013902:Radiography, Thoracic; D013272:Stomach Diseases / Q000175:diagnosis*; D014463:Ultrasonography; D015431:Weight Loss
Altération de l'état général inexpliquée du sujet âgé: intérêt de la fibroscopie gastrique, étude d'une cohorte de 77 patients avec un suivi à 13 mois.