title: Effect of dementia on outcomes of elderly patients with hemorrhagic peptic ulcer disease based on a national administrative database.
abstract: BACKGROUND
  Little information is available on the effect of dementia on outcomes of elderly patients with hemorrhagic peptic ulcer disease at the population level.
  
  
  OBJECTIVE
  This study aimed to investigate the effect of dementia on outcomes of elderly patients with hemorrhagic peptic ulcer based on a national administrative database.
  
  
  METHODS
  A total of 14,569 elderly patients (≥80 years) who were treated by endoscopic hemostasis for hemorrhagic peptic ulcer were referred to 1073 hospitals between 2010 and 2012 in Japan. We collected patients' data from the administrative database to compare clinical and medical economic outcomes of elderly patients with hemorrhagic peptic ulcers. Patients were divided into two groups according to the presence of dementia: patients with dementia (n = 695) and those without dementia (n = 13,874).
  
  
  RESULTS
  There were no significant differences in in-hospital mortality within 30 days and overall mortality between the groups (odds ratio; OR 1.00, 95 % confidence interval; CI 0.68-1.46, p = 0.986 and OR 1.02, 95 % CI 0.74-1.41, p = 0.877). However, the length of stay (LOS) and medical costs during hospitalization were significantly higher in patients with dementia compared with those without dementia. The unstandardized coefficient for LOS was 3.12 days (95 % CI 1.58-4.67 days, p < 0.001), whereas that for medical costs was 1171.7 US dollars (95 % CI 533.8-1809.5 US dollars, p < 0.001).
  
  
  CONCLUSIONS
  Length of stay and medical costs during hospitalization are significantly increased in elderly patients with dementia undergoing endoscopic hemostasis for hemorrhagic peptic ulcer disease.
authors.affiliation: Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan. amurata@med.uoeh-u.ac.jp.
authors.forename: Atsuhiko
authors.initials: A
authors.lastname: Murata
authors.affiliation: Department of Emergency Medicine, University of Occupational, Environmental and Health, Kitakyushu, Fukuoka, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Mayumi
authors.affiliation: Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Muramatsu
authors.affiliation: Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Ohtani
authors.affiliation: Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, Fukuoka, 807-8555, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Matsuda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003365:Costs and Cost Analysis; D016208:Databases, Factual; D003704:Dementia / Q000191:economics / Q000453:epidemiology / Q000503:physiopathology; D016099:Endoscopy, Gastrointestinal / Q000706:statistics & numerical data; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods / Q000706:statistics & numerical data*; D017052:Hospital Mortality; D006760:Hospitalization / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan / Q000453:epidemiology; D007902:Length of Stay; D008297:Male; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D010438:Peptic Ulcer Hemorrhage / Q000401:mortality / Q000523:psychology / Q000628:therapy
keywords: Dementia; Elderly patient; Hemorrhagic peptic ulcer; National administrative database; Outcome