title: Factors involved in gastrointestinal bleeding in advanced cancer patients followed at home.
abstract: There is a lack of information on the frequency of symptomatic gastrointestinal bleeding in patients with advanced cancer. This group of patients presents several risk factors for developing gastrointestinal bleeding. The aim of this multicenter longitudinal survey was to assess the frequency of gastrointestinal bleeding and possible factors implicated in advanced cancer patients followed at home. A consecutive sample of 439 patients who referred to home palliative care program entered the study. Age, gender, primary cancer and known metastases, possible associated pathologies, history of peptic disease, use of previous or actual nonsteroidal anti-inflammatory drugs (NSAIDs) and steroids, drugs used to prevent gastric complications, the occurrence of hematemesis or melena, significant anemia requiring blood transfusion, and mortality associated with the hemorrhagic event were recorded. Of 377 patients who completed the study, 18 reported gastrointestinal bleeding, and five had significant anemia requiring blood transfusion in three cases. Death was found to be related to bleeding in three patients. NSAIDs, steroids, and gastroprotectors were frequently used, either before or during home care. However, no clear relationship between age, gender, and the use of offender drugs with gastrointestinal bleeding was found. Liver involvement was frequently associated with the risk of developing gastrointestinal bleeding.
authors.affiliation: Anesthesia and Intensive Care Unit and Pain Relief and Palliative Care Unit, La Maddalena Cancer Center, Via S.Lorenzo 312, 90145, Palermo, Italy. terapiadeldolore@la-maddalena.it
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Mercadante
authors.forename: Flavio
authors.initials: F
authors.lastname: Fusco
authors.forename: Alessandro
authors.initials: A
authors.lastname: Valle
authors.forename: Fabio
authors.initials: F
authors.lastname: Fulfaro
authors.forename: Alessandra
authors.initials: A
authors.lastname: Casuccio
authors.forename: Stefania
authors.initials: S
authors.lastname: Silvestro
authors.forename: Emanuela
authors.initials: E
authors.lastname: Donelli
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005765:Gastrointestinal Agents / Q000627:therapeutic use; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D006699:Home Care Services; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009369:Neoplasms / Q000150:complications* / Q000628:therapy; D010166:Palliative Care; D011446:Prospective Studies; D012307:Risk Factors; D013256:Steroids / Q000627:therapeutic use
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D005765:Gastrointestinal Agents; D013256:Steroids