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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

Baseline and post-endoscopy human brain natriuretic peptide (hBNP) levels in patients aged <65 years and patients ≥65 years with and without cardiovascular disease. All data were expressed as mean ± SD. Analyses were conducted using Student’s t test. In the ≥65 year age group with cardiovascular disease, hBNP level was significantly greater than at baseline (p<0.05).
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Figure 3: Baseline and post-endoscopy human brain natriuretic peptide (hBNP) levels in patients aged <65 years and patients ≥65 years with and without cardiovascular disease. All data were expressed as mean ± SD. Analyses were conducted using Student’s t test. In the ≥65 year age group with cardiovascular disease, hBNP level was significantly greater than at baseline (p<0.05).

Mentions: In the younger group, there were no significant changes from baseline in hANP (Fig. 2) or hBNP (Fig. 3) levels measured after endoscopy. However, in the elderly group, regardless of whether cardiovascular disease was present or not, hANP level post-endoscopy was significantly greater than at baseline (p<0.01), indicating an increased atrial load associated with endoscopy (Fig. 2). In contrast, the increase from baseline in hBNP level, indicating an increased ventricular load, was only statistically significant (p<0.05) in elderly patients with cardiovascular disease (Fig. 3).


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)

Baseline and post-endoscopy human brain natriuretic peptide (hBNP) levels in patients aged <65 years and patients ≥65 years with and without cardiovascular disease. All data were expressed as mean ± SD. Analyses were conducted using Student’s t test. In the ≥65 year age group with cardiovascular disease, hBNP level was significantly greater than at baseline (p<0.05).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 3: Baseline and post-endoscopy human brain natriuretic peptide (hBNP) levels in patients aged <65 years and patients ≥65 years with and without cardiovascular disease. All data were expressed as mean ± SD. Analyses were conducted using Student’s t test. In the ≥65 year age group with cardiovascular disease, hBNP level was significantly greater than at baseline (p<0.05).
Mentions: In the younger group, there were no significant changes from baseline in hANP (Fig. 2) or hBNP (Fig. 3) levels measured after endoscopy. However, in the elderly group, regardless of whether cardiovascular disease was present or not, hANP level post-endoscopy was significantly greater than at baseline (p<0.01), indicating an increased atrial load associated with endoscopy (Fig. 2). In contrast, the increase from baseline in hBNP level, indicating an increased ventricular load, was only statistically significant (p<0.05) in elderly patients with cardiovascular disease (Fig. 3).

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