Enfermedad Inflamatoria Intestinal en el adulto mayor: Características clínicas y manejo en un hospital de referencia

Autores/as

DOI:

https://doi.org/10.47892/rgp.2023.431.1444

Palabras clave:

Enfermedad inflamatoria intestinal, adulto mayor, manejo, Colitis Ulcerosa, Enfermedad de Crohn, Anciano

Resumen

La enfermedad inflamatoria intestinal (EII) en adultos mayores se caracteriza por su variabilidad clínica, distintos diagnósticos diferenciales y manejo terapéutico. El objetivo de la presente investigación es evaluar las características clínicas y manejo de los pacientes adultos mayores con EII. Se realizó un estudio observacional, descriptivo, retrospectivo de enero del 2011 a diciembre del 2019 en pacientes con EII en el Servicio de Gastroenterología del Hospital Nacional Guillermo Almenara Irigoyen, Lima-Perú. Fueron evaluados 55 pacientes con EC y 107 con CU; 45,6% de pacientes con EII eran adultos mayores. De ellos, 28 tenían EC y 46 CU. Los adultos mayores con EC presentaron fenotipo inflamatorio y localización colónica predominantemente, mientras en CU, la colitis extensa e izquierda fueron las más frecuentes. Asimismo, los ancianos tuvieron menor puntaje CDAI (279,8 vs 323,2) y menor índice de Mayo (7,1 vs 9,2) con relación a los pacientes jóvenes, sin diferencias significativas. Respecto al tratamiento, se observó un menor uso de azatioprina (2 vs 8, p<0,03) y Anti-TNF (9 vs 18, p<0,01) en los adultos mayores con EC. La necesidad de cirugía y la frecuencia de complicaciones post quirúrgicas fueron similares entre ambos grupos. En conclusión, casi la mitad de los pacientes con EII son adultos mayores. La localización colónica fue la más frecuente en EC, y en CU la colitis extensa e izquierda. Observamos un menor uso de azatiopri a y terapia biológica en adultos mayores, sin diferencias significativas en el uso de corticoides y aminosalicilatos respecto a los jóvenes.

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Biografía del autor/a

Juan Eloy Paredes-Méndez, Servicio de Gastroenterología Hospital Nacional Guillermo Almenara Irigoyen

Médico Asistente del Servicio de Gastroenterología del Hospital Nacional Guillermo Almenara Irigoyen - EsSalud. Lima - Perú

Sonia Irene Junes-Pérez, Servicio de Gastroenterología Hospital Nacional Guillermo Almenara Irigoyen

Médico Asistente del Servicio de Gastroenterología del Hospital Nacional Guillermo Almenara Irigoyen - EsSalud. Lima - Perú

Henry Tomás Vargas-Marcacuzco, Servicio de Gastroenterología Hospital Nacional Guillermo Almenara Irigoyen

Médico Asistente del Servicio de Gastroenterología del Hospital Nacional Guillermo Almenara Irigoyen - EsSalud. Lima - Perú

Edith Melissa Villafuerte-Méndez, Servicio de Gastroenterología Hospital Nacional Guillermo Almenara Irigoyen

Médico Asistente del Servicio de Gastroenterología del Hospital Nacional Guillermo Almenara Irigoyen - EsSalud. Lima - Perú

Citas

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Publicado

11.04.2023

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1.
Paredes Méndez JE, Pérez Junes SI, Vargas Marcacuzco HT, Villafuerte Méndez EM. Enfermedad Inflamatoria Intestinal en el adulto mayor: Características clínicas y manejo en un hospital de referencia. Rev Gastroenterol Peru [nternet]. 11 de abril de 2023 [citado 10 de junio de 2023];43(1):13-9. isponible en: https://revistagastroperu.com/index.php/rgp/article/view/1444

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