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Effect of dementia on outcomes of elderly patients with hemorrhagic peptic ulcer disease based on a national administrative database

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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.

Aims

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.

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References

  1. Murata A, Matsuda S, Kuwabara K, Ichimiya Y, Matsuda Y, Kubo T, Fujino Y, Fujimori K, Horiguchi H (2013) Association between hospital volume and outcomes of elderly and non-elderly patients with acute biliary diseases: a national administrative database analysis. Geriatr Gerontol Int 13:731–740

    Article  PubMed  Google Scholar 

  2. Kalaria RN, Maestre GE, Arizaga R, Friedland RP, Galasko D, Hall K, Luchsinger JA, Ogunniyi A, Perry EK, Potocnik F, Prince M, Stewart R, Wimo A, Zhang ZX, Antuono P, World Federation of Neurology Dementia Research Group (2008) Alzheimer’s disease and vascular dementia in developing countries: prevalence, management, and risk factors. Lancet Neurol 7:812–826

    Article  PubMed Central  PubMed  Google Scholar 

  3. Sekita A, Ninomiya T, Tanizaki Y, Doi Y, Hata J, Yonemoto K, Arima H, Sasaki K, Iida M, Iwaki T, Kanba S, Kiyohara Y (2010) Trends in prevalence of Alzheimer’s disease and vascular dementia in a Japanese community: the Hisayama Study. Acta Psychiatr Scand 122:319–325

    Article  CAS  PubMed  Google Scholar 

  4. Berr C, Wancata J, Ritchie K (2005) Prevalence of dementia in the elderly in Europe. Eur Neuropsychopharmacol 15:463–471

    Article  CAS  PubMed  Google Scholar 

  5. Prince M, Acosta D, Ferri CP, Guerra M, Huang Y, Llibre Rodriguez JJ, Salas A, Sosa AL, Williams JD, Dewey ME, Acosta I, Jotheeswaran AT, Liu Z (2012) Dementia incidence and mortality in middle-income countries, and associations with indicators of cognitive reserve: a 10/66 Dementia Research Group population-based cohort study. Lancet 380:50–58

    Article  PubMed Central  PubMed  Google Scholar 

  6. Prince M, Bryce R, Albanese E, Wimo A, Ribeiro W, Ferri CP (2013) The global prevalence of dementia: a systematic review and metaanalysis. Alzheimers Dement 9:63–75

    Article  PubMed  Google Scholar 

  7. Murata A, Matsuda S, Kuwabara K, Ichimiya Y, Fujino Y, Kubo T, Fujimori K, Horiguchi H (2011) Equivalent clinical outcomes of bleeding peptic ulcers in teaching and non-teaching hospitals: evidence for standardization of medical care in Japan. Tohoku J Exp Med 223:1–7

    Article  PubMed  Google Scholar 

  8. Murata A, Matsuda S, Kuwabara K, Ichimiya Y, Fujino Y, Kubo T (2012) The influence of diabetes mellitus on short-term outcomes of patients with bleeding peptic ulcers. Yonsei Med J 53:701–707

    Article  PubMed Central  PubMed  Google Scholar 

  9. Theocharis GJ, Thomopoulos KC, Sakellaropoulos G, Katsakoulis E, Nikolopoulou V (2008) Changing trends in the epidemiology and clinical outcome of acute upper gastrointestinal bleeding in a defined geographical area in Greece. J Clin Gastroenterol 42:128–133

    Article  PubMed  Google Scholar 

  10. Lewis JD, Shin EJ, Metz DC (2000) Characterization of gastrointestinal bleeding in severely ill hospitalized patients. Crit Care Med 28:46–50

    Article  CAS  PubMed  Google Scholar 

  11. Marmo R, Koch M, Cipolletta L, Capurso L, Pera A, Bianco MA, Rocca R, Dezi A, Fasoli R, Brunati S, Lorenzini I, Germani U, Di Matteo G, Giorgio P, Imperiali G, Minoli G, Barberani F, Boschetto S, Martorano M, Gatto G, Amuso M, Pastorelli A, Torre ES, Triossi O, Buzzi A, Cestari R, Della Casa D, Proietti M, Tanzilli A, Aragona G, Giangregorio F, Allegretta L, Tronci S, Michetti P, Romagnoli P, Nucci A, Rogai F, Piubello W, Tebaldi M, Bonfante F, Casadei A, Cortini C, Chiozzini G, Girardi L, Leoci C, Bagnalasta G, Segato S, Chianese G, Salvagnini M, Rotondano G (2008) Predictive factors of mortality from nonvariceal upper gastrointestinal hemorrhage: a multicenter study. Am J Gastroenterol 103:1639–1647

    Article  PubMed  Google Scholar 

  12. Bakkevold KE (2010) Time trends in incidence of peptic ulcer bleeding and associated risk factors in Norway 1985–2008. Clin Exp Gastroenterol 23:71–77

    Article  Google Scholar 

  13. Christensen S, Riis A, Nørgaard M, Sørensen HT, Thomsen RW (2007) Short-term mortality after perforated or bleeding peptic ulcer among elderly patients: a population-based cohort study. BMC Geriatr 7:8

    Article  PubMed Central  PubMed  Google Scholar 

  14. Murata A, Matsuda S (2013) Association between ambulance distance to hospitals and mortality from acute diseases in Japan: national database analysis. J Public Health Manag Pract 19:E23–E28

    Article  PubMed  Google Scholar 

  15. Murata A, Okamoto K, Muramatsu K, Kubo T, Fujino Y, Matsuda S (2014) Effects of additional laparoscopic cholecystectomy on outcomes of laparoscopic gastrectomy in patients with gastric cancer based on a national administrative database. J Surg Res 186:157–163

    Article  PubMed  Google Scholar 

  16. Murata A, Muramatsu K, Ichimiya Y, Kubo T, Fujino Y, Matsuda S (2014) Endoscopic submucosal dissection for gastric cancer in elderly Japanese patients: an observational study of financial costs of treatment based on a national administrative database. J Dig Dis 15:62–70

    Article  PubMed  Google Scholar 

  17. Murata A, Okamoto K, Muramatsu K, Matsuda S (2014) Endoscopic submucosal dissection for gastric cancer: the influence of hospital volume on complications and length of stay. Surg Endosc 28:1298–1306

    Article  PubMed  Google Scholar 

  18. Murata A, Okamoto K, Mayumi T, Muramatsu K, Matsuda S (2014) Age-related differences in outcomes and etiologies of acute abdominal pain based on a national administrative database. Tohoku J Exp Med 233:9–15

    Article  PubMed  Google Scholar 

  19. Chow LWC, Gertsch P, Poon RT, Branicki FJ (1998) Risk factors for rebleeding and death from peptic ulcer in the very elderly. Br J Surg 85:121–124

    Article  CAS  PubMed  Google Scholar 

  20. Yamaguchi Y, Yamato T, Katsumi N, Morozumi K, Abe T, Ishida H, Takahashi S (2003) Endoscopic hemostasis: safe treatment for peptic ulcer patients aged 80 years or older? J Gastroenterol Hepatol 18:521–525

    Article  PubMed  Google Scholar 

  21. Murata A, Okamoto K, Mayumi T, Muramatsu K, Matsuda S (2014) The recent time trend of outcomes of disseminated intravascular coagulation in Japan: an observational study based on a national administrative database. J Thromb Thrombolysis 38:364–371

    Article  PubMed  Google Scholar 

  22. Feng P, Zhou XH, Zou QM, Fan MY, Li XS (2012) Generalized propensity score for estimating the average treatment effect of multiple treatments. Stat Med 31:681–697

    Article  PubMed  Google Scholar 

  23. Stukel TA, Fisher ES, Wennberg DE, Alter DA, Gottlieb DJ, Vermeulen MJ (2007) Analysis of observational studies in the presence of treatment selection bias: effects of invasive cardiac management on AMI survival using propensity score and instrumental variable methods. JAMA 297:278–285

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  24. Westreich D, Lessler J, Funk MJ (2010) Propensity score estimation: neural networks, support vector machines, decision trees (CART), and meta-classifiers as alternatives to logistic regression. J Clin Epidemiol 63:826–833

    Article  PubMed Central  PubMed  Google Scholar 

  25. Yachimski PS, Friedman LS (2008) Gastrointestinal bleeding in the elderly. Nat Clin Pract Gastroenterol Hepatol 5:80–93

    Article  PubMed  Google Scholar 

  26. Young J, Inouye SK (2007) Delirium in older people. BMJ 334:842–846

    Article  PubMed Central  PubMed  Google Scholar 

  27. Robinson TN, Raeburn CD, Tran ZV, Angles EM, Brenner LA, Moss M (2009) Postoperative delirium in the elderly: risk factors and outcomes. Ann Surg 249:173–178

    Article  PubMed  Google Scholar 

  28. Saravay SM, Kaplowitz M, Kurek J, Zeman D, Pollack S, Novik S, Knowlton S, Brendel M, Hoffman L (2004) How do delirium and dementia increase length of stay of elderly general medical inpatients? Psychosomatics 45:235–242

    Article  PubMed  Google Scholar 

  29. Han JH, Eden S, Shintani A, Morandi A, Schnelle J, Dittus RS, Storrow AB, Ely EW (2011) Delirium in older emergency department patients is an independent predictor of hospital length of stay. Acad Emerg Med 18:451–457

    Article  PubMed Central  PubMed  Google Scholar 

  30. Sugawara N, Tanaka O, Yasui-Furukori N (2015) Effects of the 2004 postgraduate training program on the interprefectural distribution of psychiatrists in Japan. Psychiatry Clin Neurosci 69:117–121

    Article  PubMed  Google Scholar 

  31. Inagaki A, Mizuno M, Fujiwara S, Enokido F, Tsujino N, Nemoto Y, Nozaki S, Kojima T (2012) Survey on the actual condition of psychiatrists and psychiatric services in Japan. (Part 2): Change in geographical working area and setting of each psychiatrist. Seishin Shinkeigaku Zasshi 14:1374–1384 (Japanese)

    Google Scholar 

  32. Mizuno M, Inagaki A, Fujiwara S, Enokido F, Tsujino N, Nemoto Y, Nozaki S, Kojima T (2012) Survey on the actual condition of psychiatrists and psychiatric services in Japan. (Part 1): Basic data on number and distribution of psychiatrists. Seishin Shinkeigaku Zasshi 114:1359–1373 (Japanese)

    PubMed  Google Scholar 

  33. Tagami T, Matsui H, Horiguchi H, Fushimi K, Yasunaga H (2014) Antithrombin and mortality in severe pneumonia patients with sepsis-associated disseminated intravascular coagulation: an observational nationwide study. J Thromb Haemost 12:1470–1479

    Article  CAS  PubMed  Google Scholar 

  34. Hirota C, Watanabe M, Sun W, Tanimoto Y, Kono R, Takasaki K, Kono K (2010) Association between the Trail Making Test and physical performance in elderly Japanese. Geriatr Gerontol Int 10:40–47

    Article  PubMed  Google Scholar 

  35. Iwamoto Y, Yamada T, Kawanishi C (2010) Effect of psychiatric and psychosocial intervention on suicide attempters who were admitted to a critical emergency unit: active engagement of full-time psychiatrists in the unit with attempters. Seishinigaku 52:87–90 (Japanese)

    Google Scholar 

  36. Michaud L, Büla C, Berney A, Camus V, Voellinger R, Stiefel F, Burnand B, Delirium Guidelines Development Group (2007) Delirium: guidelines for general hospitals. J Psychosom Res 62:371–383

    Article  PubMed  Google Scholar 

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Acknowledgments

This study was funded by Grants-in-Aid for Research on Policy Planning and Evaluation from the Ministry of Health, Labour, and Welfare, Japan.

Conflict of interest

None of the authors have any conflicts of interest to declare.

Author information

Authors and Affiliations

  1. 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

    Atsuhiko Murata, Keiji Muramatsu, Makoto Ohtani & Shinya Matsuda

  2. Department of Emergency Medicine, University of Occupational, Environmental and Health, Kitakyushu, Fukuoka, Japan

    Toshihiko Mayumi

Authors
  1. Atsuhiko Murata
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  2. Toshihiko Mayumi
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  3. Keiji Muramatsu
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  4. Makoto Ohtani
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  5. Shinya Matsuda
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Corresponding author

Correspondence to Atsuhiko Murata.

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Murata, A., Mayumi, T., Muramatsu, K. et al. Effect of dementia on outcomes of elderly patients with hemorrhagic peptic ulcer disease based on a national administrative database. Aging Clin Exp Res 27, 717–725 (2015). https://doi.org/10.1007/s40520-015-0328-1

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  • DOI: https://doi.org/10.1007/s40520-015-0328-1

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