Assessment of upper gastrointestinal endoscopy tolerance in elderly subjects

The quality of life and the comfort of the patients during medical investigations represent one of the priorities of the elderly management in hospital. This study assesses the tolerance of the upper digestive tract endoscopy (UGIE) in a population of patients older than 70 years, hospitalized in a geriatric acute care unit. This prospective study was conducted from november 2 nd, 2007 to march 6 th, 2008. The main objective was to assess UGIE tolerance on the basis of the primary outcome: the patient's acceptance to undergo the examination again under the same conditions. The subjective patient's evaluation of the secondary outcomes was measured using the visual analog scale (VAS) with the range 1-10. The aim was to suggest solutions for improving tolerance. Thirty patients were included; 19 women and 11 men. The mean age of patients was 84.3 years and the median age was 85.5 years. The most frequent ground for hospitalization was the deterioration of general state. UGIE was mostly performed for assessing anemia (11 cases) and isolated weight loss (8 cases). It was well tolerated in twenty out of thirty patients and the acceptance rate to repeat the same procedure was 66%. No complications were noted at the time of the UGIE in our study. Sixteen out of thirty patients (53.3%) did not experience any pain. The VAS mean score was 2.36/10 for all patients. Twenty patients (66.7%) did not feel suffocation sensation. The VAS mean score for suffocation sesation was 1.44/10 for all patients. Eighteen patients (60%) did not complain of nausea during the examination. The VAS mean score for nausea was 2/10. Sixteen out of thirty patients (53.3%) were not anxious at the time of the procedure. The VAS mean score for anxiety was 2.7/10 for all patients’ study and 5.8/10 for anxious subjects. A significant relation (p<0.05) was found between UGIE tolerance in elderly subjects and secondary outcomes. The refusal to repeat the examination was significantly related to severe pain, high anxiety level, or strong feeling of nausea and suffocation. These parameters have to be improved. The upper digestive tract endoscopy is well tolerated in the majority of patients older than 70 years.