Clinical analysis of Crohn's disease in the elderly / 中华老年医学杂志

ABSTRACT

Objective To analyze clinical characteristics of crohn's disease in the elderly in order to reduce the rate of misdiagnosis in Crohn's disease in elderly people.Methods Patients with Crohn's disease were divided into elderly group (n=80) and young and middle-aged group (n=100).Clinical manifestations,complications,laboratory test results and misdiagnosis rate were retrospectively analyzed.Results Diarrhea rate was higher in elderly group than in young and middle-aged group (62.5％ vs.28％,x2 =21.54,P＜0.05).The incidence of bloody/pus stools was lower in elderly group than in young and middle-aged group (16.3％ vs.30.0％,x2 =4.621,P＜0.05).Ileus and perianal diseases incidence rates were lower in elderly group than in young and middle-aged group (20.0％ vs.36.0％,1.3％ vs.8.0％,x2=5.538 and 4.263,P＜0.05).Crohn's disease showed more decreased serum albumin,decreased hemoglobin and ESR in elderly group,which accounted for 48.8％,41.3％,and 38.8％ respectively,but there were no differences between the two groups (all P＞0.05).Compared with young and middle-aged group,Crohn's disease was more likely misdiagnosed as colon cancer and ischemic bowel disease in elderly group (x2 =16.05 and 16.07,both P＜ 0.05).Crohn's disease was more likely misdiagnosed as appendicitis,intestinal tuberculosis and ulcerative colitis in young and middle-aged group than in elderly group (x2=4.707,6.210,4.792,respectively,all P＜0.05).Conclusions Crohn's disease in elderly people occurs with more severe diarrheas,less blood and pus stools,less obstruction and perianal lesions as compared with young group,to which we should pay more attention.