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Risk management for gastrointestinal endoscopy in elderly patients: questionnaire for patients undergoing gastrointestinal endoscopy.

Umegaki E, Abe S, Tokioka S, Takeuchi N, Takeuchi T, Yoda Y, Murano M, Higuchi K - J Clin Biochem Nutr (2009)

Bottom Line: Evaluation of subjects divided into under 65 and over 65 age groups revealed that in subjects aged 65 and over, risk factors for anticholinergic agents were significantly more high than those for glucagon.Analysis of the cardiovascular effects of anticholinergic agents and glucagon, in the elderly patients showed that hANP levels were significantly higher following administration of anticholinergic agents, but the change was not significant for glucagon premedication.Taking a detailed history before UGITE with the aid of a questionnaire at the same time as informed consent is obtained, is extremely useful in terms of risk management and selection of the appropriate premedication.

View Article: PubMed Central - PubMed

Affiliation: Second Department of Internal Medicine, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-shi, Osaka 569-8686, Japan.

ABSTRACT
More elderly patients now undergo gastrointestinal endoscopy following recent advances in endoscopic techniques. In this study, we conducted a high-risk survey of endoscopies in Japan, using a questionnaire administered prior to upper gastrointestinal tract endoscopy (UGITE), and identified anticholinergic agents and glucagon preparations as high-risk premedication. We also evaluated the cardiovascular effects of anticholinergic agents and glucagon through measurements of plasma levels of human atrial natriuretic peptide (hANP) and human brain natriuretic peptide (hBNP). The subjects were 1480 patients who underwent UGITE. Nurses administered a pre-endoscopy questionnaire, questioning subjects regarding heart disease, hypertension, glaucoma, and urinary difficulties as risk factors for anticholinergic agents, and Diabetes mellitus as a risk factor for glucagon preparations. Evaluation of subjects divided into under 65 and over 65 age groups revealed that in subjects aged 65 and over, risk factors for anticholinergic agents were significantly more high than those for glucagon. Analysis of the cardiovascular effects of anticholinergic agents and glucagon, in the elderly patients showed that hANP levels were significantly higher following administration of anticholinergic agents, but the change was not significant for glucagon premedication. Taking a detailed history before UGITE with the aid of a questionnaire at the same time as informed consent is obtained, is extremely useful in terms of risk management and selection of the appropriate premedication.

No MeSH data available.


Related in: MedlinePlus

Detail of pre-endoscopy questionnaire developed at Osaka Medical College Gastrointestinal Endoscopy Center.
© Copyright Policy - open-access
Related In: Results  -  Collection


getmorefigures.php?uid=PMC2803136&req=5

Figure 1: Detail of pre-endoscopy questionnaire developed at Osaka Medical College Gastrointestinal Endoscopy Center.

Mentions: A doctor or nurse administered the oral pre-endoscopy questionnaire, which is shown in Figure 1. The questions were developed to detect background factors, including underlying conditions and medication, in each subject to help in risk management and reducing endoscopy complications. The <65 (younger) and ≥65 age groups (elderly) were compared for five characteristics or clinical conditions deemed high-risk for complications: 1) first-time endoscopy; 2) lignocaine allergy; 3) antithrombotic therapy (e.g., warfarin, ticlopidine, aspirin); 4) heart disease (arrhythmia, ischemic heart disease), hypertension, glaucoma, prostatic hypertrophy; and 5) Diabetes mellitus.


Risk management for gastrointestinal endoscopy in elderly patients: questionnaire for patients undergoing gastrointestinal endoscopy.

Umegaki E, Abe S, Tokioka S, Takeuchi N, Takeuchi T, Yoda Y, Murano M, Higuchi K - J Clin Biochem Nutr (2009)

Detail of pre-endoscopy questionnaire developed at Osaka Medical College Gastrointestinal Endoscopy Center.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2803136&req=5

Figure 1: Detail of pre-endoscopy questionnaire developed at Osaka Medical College Gastrointestinal Endoscopy Center.
Mentions: A doctor or nurse administered the oral pre-endoscopy questionnaire, which is shown in Figure 1. The questions were developed to detect background factors, including underlying conditions and medication, in each subject to help in risk management and reducing endoscopy complications. The <65 (younger) and ≥65 age groups (elderly) were compared for five characteristics or clinical conditions deemed high-risk for complications: 1) first-time endoscopy; 2) lignocaine allergy; 3) antithrombotic therapy (e.g., warfarin, ticlopidine, aspirin); 4) heart disease (arrhythmia, ischemic heart disease), hypertension, glaucoma, prostatic hypertrophy; and 5) Diabetes mellitus.

Bottom Line: Evaluation of subjects divided into under 65 and over 65 age groups revealed that in subjects aged 65 and over, risk factors for anticholinergic agents were significantly more high than those for glucagon.Analysis of the cardiovascular effects of anticholinergic agents and glucagon, in the elderly patients showed that hANP levels were significantly higher following administration of anticholinergic agents, but the change was not significant for glucagon premedication.Taking a detailed history before UGITE with the aid of a questionnaire at the same time as informed consent is obtained, is extremely useful in terms of risk management and selection of the appropriate premedication.

View Article: PubMed Central - PubMed

Affiliation: Second Department of Internal Medicine, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-shi, Osaka 569-8686, Japan.

ABSTRACT
More elderly patients now undergo gastrointestinal endoscopy following recent advances in endoscopic techniques. In this study, we conducted a high-risk survey of endoscopies in Japan, using a questionnaire administered prior to upper gastrointestinal tract endoscopy (UGITE), and identified anticholinergic agents and glucagon preparations as high-risk premedication. We also evaluated the cardiovascular effects of anticholinergic agents and glucagon through measurements of plasma levels of human atrial natriuretic peptide (hANP) and human brain natriuretic peptide (hBNP). The subjects were 1480 patients who underwent UGITE. Nurses administered a pre-endoscopy questionnaire, questioning subjects regarding heart disease, hypertension, glaucoma, and urinary difficulties as risk factors for anticholinergic agents, and Diabetes mellitus as a risk factor for glucagon preparations. Evaluation of subjects divided into under 65 and over 65 age groups revealed that in subjects aged 65 and over, risk factors for anticholinergic agents were significantly more high than those for glucagon. Analysis of the cardiovascular effects of anticholinergic agents and glucagon, in the elderly patients showed that hANP levels were significantly higher following administration of anticholinergic agents, but the change was not significant for glucagon premedication. Taking a detailed history before UGITE with the aid of a questionnaire at the same time as informed consent is obtained, is extremely useful in terms of risk management and selection of the appropriate premedication.

No MeSH data available.


Related in: MedlinePlus