title: Low-dose aspirin and comorbidities are significantly related to bleeding peptic ulcers in elderly patients compared with nonelderly patients in Japan.
abstract: OBJECTIVE
  The present study was conducted using data accumulated from our earlier study of bleeding peptic ulcers, focusing on elderly patients.
  
  
  METHODS
  A total of 461 patients with bleeding peptic ulcers underwent emergency endoscopy at Saga Medical School Hospital between 1999 and 2011. Risk factors for bleeding peptic ulcers were compared between two groups: an elderly group (≥65 years old) and a nonelderly group (<65 years old). The relationship between drug use and age was examined using multiple logistic regression models. In the elderly group, the factors were compared between Period I (1999-2005) and Period II (2006-2011).
  
  
  RESULTS
  The proportion of men and the incidence of Helicobacter pylori infection were lower in the elderly group than in the nonelderly group. The use of low-dose aspirin, antithrombotic drugs and corticosteroids, but not nonsteroidal anti-inflammatory drugs, was higher in the elderly group. A multiple logistic regression analysis of prescribed medications indicated that low-dose aspirin was more frequently used in the elderly group. The rate of comorbidities was higher and the hemoglobin levels were lower in the elderly group. The rates of rebleeding within one week and death within one month did not differ in the elderly group. Compared with that observed in Period I, the incidence of Helicobacter pylori infection was decreased and the rate of comorbidities was increased in Period II.
  
  
  CONCLUSIONS
  This study indicates that factors related to bleeding peptic ulcers in elderly patients have shifted from Helicobacter pylori infection to comorbidities associated with low-dose aspirin, suggesting a close relationship between low-dose aspirin therapy and comorbidities in elderly patients with peptic ulcers.
authors.affiliation: Departments of Internal Medicine and Gastrointestinal Endoscopy, Saga Medical School, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Higuchi
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Iwakiri
authors.forename: Megumi
authors.initials: M
authors.lastname: Hara
authors.forename: Ryo
authors.initials: R
authors.lastname: Shimoda
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Sakata
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakayama
authors.forename: Kenta
authors.initials: K
authors.lastname: Nio
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Yamaguchi
authors.forename: Daisuke
authors.initials: D
authors.lastname: Yamaguchi
authors.forename: Akira
authors.initials: A
authors.lastname: Watanabe
authors.forename: Takashi
authors.initials: T
authors.lastname: Akutagawa
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Sakata
authors.forename: Kazuma
authors.initials: K
authors.lastname: Fujimoto
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects; D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects*; D015897:Comorbidity; D004305:Dose-Response Relationship, Drug; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005500:Follow-Up Studies; D016481:Helicobacter Infections / Q000453:epidemiology* / Q000382:microbiology; D016480:Helicobacter pylori / Q000302:isolation & purification*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010438:Peptic Ulcer Hemorrhage / Q000175:diagnosis / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D013276:Stomach Ulcer / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin