Acute upper gastrointestinal bleeding in octοgenarians: Clinical outcome and factors related to mortality

Abstract

AIM:To evaluate the aetiology, clinical outcome and factors related to mortality of acute upper gastrointestinal bleeding (AUGIB) in octogenarians. METHODS:We reviewed the records of all patients over 65 years old who were hospitalised with AUGIB in two hospitals from January 2006 to December of 2006. Patients were divided into two groups: Group A (65-80 years old) and Group B (> 80 years old). RESULTS: Fo u r h u n d re d a n d s i x t e e n p a t i e n t s over 65 years of age were hospitalized because of AUGIB. Group A included 269 patients and Group B 147 patients. Co-morbidity was more common in octogenarians (P = 0.04). The main cause of bleeding was peptic ulcer in both groups. Rebleeding and emergency surgery were uncommon in octogenarians and not different from those in younger patients. In-hospital complications were more common in octogenarians (P = 0.05) and more patients died in the group of octogenarians compared to the younger age group (P = 0.02). Inability to perform endoscopic examination (P = 0.002), presence of high risk for rebleeding stigmata (P = 0.004), urea on admission (P = 0.036), rebleeding (P = 0.004) and presence of severe co-morbidity (P < 0.0001) were related to mortality. In multivariate analysis, only the presence of severe co-morbidity was independently related to mortality (P = 0.032). CONCLUSION: While rebleeding and emergency surgery rates are relatively low in octogenarians with AUGIB, the presence of severe co-morbidity is the main factor of adverse outcome.

Risk factors of the rebleeding according to the patterns of nonvariceal upper gastrointestinal bleeding

“…However, there have been a few conflicting reports that evaluated whether the risk of rebleeding was increased with greater age (11,30). Because older patients may have a possibility of having a more complicated comorbidity and are vulnerable to recovery from initial hemodynamic instability, they might have high risk for rebleeding and high mortality rate.…”

Épidémiologie, étiologie et évolution des hémorragies digestives hautes au centre hospitalier universitaire de Fès, Maroc

“…L'incidence des HDH augmente chez les sujets âgés, et ces derniers sont devenus majoritaires dans les séries d'HDH rapportées en Europe ou en Amérique du Nord [1,[15][16][17][18][19]. Ainsi, les patients âgés de plus de 65 ans constituaient 65,2 % des cas [19], alors que ce taux n'était que de 20,4 % dans notre série.…”

Varis dışı üst gastrointestinal sistem kanamalı hastaların demografik ve klinik özellikleri

“…Otuz günlük tekrar kanama inisiyal endoskopik hemostazda baflar›s›zl›k ve ciddi ko-morbidite ile iliflkili bulunmufltur (13). Ko-morbidite ile mortalite aras›ndaki iliflki di¤er çal›flmalarda da gösteril-mifltir (14,15).…”