Although complications occur with long-term steroid usage in elderly Crohn's disease patients, there is little information on their short-term risk.
This study was designed to assess that risk.
We reviewed admissions from 1984 to 1995 and found 115 patients over age 50 yr with a confirmed flare of Crohn's disease.
Of this group, 55 patients were treated with steroids.
We studied potential complications including hypertension (blood pressure = 160/90), hyperglycemia (glucose>200 mg/dl), hypokalemia (K<3.5 meq/l), mental status changes, nosocomial infections, and heart failure.
The mean age was 67 yr (50-90), and 64% were women.
There were no differences in baseline characteristics between patients treated with steroids and those not treated with steroids.
The relative risk for developing complications are as follows : hypertension, 1.46 (95% confidence interval (CI)=1.09-1.95), hyperglycemia, 1.53 (95% CI=0.54-4.32), hypokalemia, 1.59 (95% CI=1.06-2.37), mental status changes, 7.64 (95% CI=0.97-60.1), nosocomial infection, 1.09 (95% CI=0.37-3.18), and congestive heart failure, 1.09 (95% CI=0.16-7.48).
Multivariate analyses adjusting for age, severity index, and number of comorbid conditions demonstrated similar findings to the unadjusted analyses.
Analyses stratified by patient age demonstrated a similar risk of steroid associated complications for patients<65 and = 65 yr of age. (...)
Mots-clés Pascal : Entérite Crohn, Traitement, Long terme, Chimiothérapie, Corticostéroïde, Complication, Iatrogène, Incidence, Morbidité, Article synthèse, Vieillard, Homme, Appareil digestif pathologie, Intestin pathologie, Maladie inflammatoire, Pharmacovigilance, Toxicologie
Mots-clés Pascal anglais : Crohn disease, Treatment, Long term, Chemotherapy, Corticosteroid, Complication, Iatrogenic, Incidence, Morbidity, Review, Elderly, Human, Digestive diseases, Intestinal disease, Inflammatory disease, Pharmacovigilance, Toxicology
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0220265
Code Inist : 002B13B03. Création : 21/05/1997.