The Prognosis of Upper Gastrointestinal Bleeding in Very Elderly Patients Is the Same As That of Younger Ones: Results of a French Prospective Multicenter Study of the ANGH Group

Nahon, Stéphane; Nouël, O; Cassan, P; Paupard, Thierry; Combes, Rémi; Kerjean, Alain; Doumet, Sylva; Cocq-Vezilier, Perrine; Tielman, Guillaume; Janicki, Eric; Bernardini, David; Antoni, M.; Haioun, Najia; Pillon, D.; Bretagnolle, Philippe; l, Angh Groupe de

doi:10.1016/j.gie.2007.03.116

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“…In a recent multicenter study from France, no difference in www.wjgnet.com Theocharis GJ et al . Acute upper GI bleeding in octοgenarians overall mortality was found among patients over and less than 75 years old, but in this study only patients with AUGIB subjected to endoscopy were included [31] . The percentage of deaths related directly to bleeding was generally low even in the very elderly, and the majority of elderly patients with AUGIB died of unpreventable causes.…”

Section: Discussionmentioning

confidence: 99%

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

Theocharis¹,

Arvaniti²,

Assimakopoulos³

et al. 2008

WJG

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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.

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Section: Discussionmentioning

confidence: 99%