Evaluation of Helicobacter pylori with a stool antigen assay in frail, elderly patients.
OBJECTIVE
Helicobacter pylori infection has not been studied thoroughly in elderly patients. The aim of this study was to evaluate the reliability of stool antigen assay (HpSA) in the assessment of H. pylori infection in hospitalized, frail, elderly patients.


METHODS
The study population consisted of 85 consecutively recruited elderly patients (> or =65 years old) hospitalized between May 1999 and December 2001 with diagnostic indications for upper gastrointestinal endoscopy. Twenty-nine subjects had been receiving treatment with proton-pump inhibitors (PPIs), such as omeprazole (10-20 mg/day) for 2-15 days, and 56 were not receiving treatment. HpSA was evaluated versus UBT (urea breath test), serology and histology: patients with at least two positive results out of the latter three tests were considered positive for H. pylori infection, while patients with at least two negative tests out of three were considered negative.


RESULTS
The sensitivity and specificity of HpSA in the 56 untreated patients were, respectively, 76% (true positives TP = 22; false negatives FN = 7) and 93% (true negatives TN = 25; false positives FP = 2). The sensitivity and specificity of HpSA in the 29 patients on PPI treatment were, respectively, 82% (TP = 9; FN = 2) and 83% (TN = 15; FP = 3).


CONCLUSIONS
HpSA is an accurate, non-invasive and easy method for diagnosing H. pylori infection in elderly patients.
Inelmen
Emine Meral
EM
Department of Medical and Surgical Sciences, Section of Geriatrics University of Padua, Italy. eminemeral.inelmen@unipd.it
Gasparini
Giulia
G
Sergi
Giuseppe
G
Enzi
Giuliano
G
D000368:Aged; D000369:Aged, 80 and over; D000942:Antigens, Bacterial / Q000032:analysis*; D001944:Breath Tests; D015331:Cohort Studies; D005069:Evaluation Studies as Topic; D005243:Feces / Q000382:microbiology*; D005260:Female; D016330:Frail Elderly; D005773:Gastroscopy / Q000379:methods; D015577:Geriatric Assessment; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000453:epidemiology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D007124:Immunoenzyme Techniques / Q000379:methods*; D008297:Male; D011237:Predictive Value of Tests; D012307:Risk Factors; D012680:Sensitivity and Specificity
D000942:Antigens, Bacterial